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Description

Medical necessity denials represent a significant financial burden for healthcare providers, incurring costs that can reach into the millions annually due to write-offs, along with the expensive labor involved in investigating and contesting these denials while addressing patient inquiries. Conversely, payers also face similar challenges in the claims management process, as they incur expenses from covering unnecessary medical procedures and treatments, as well as the resources dedicated to handling denial appeals, all of which do not contribute to better patient outcomes. Additionally, patients may suffer from excessive copays and other out-of-pocket expenses, coupled with a frustrating healthcare experience due to charges and services that are not warranted. To combat these issues, the ABN Assistant™ from Vālenz® Assurance equips providers with essential prior authorization tools to confirm medical necessity, generate Medicare-compliant Advanced Beneficiary Notices (ABNs) that include estimated costs, and effectively prevent over 90 percent of medical necessity denials by ensuring that the necessity is validated before any care is administered to the patient. By utilizing this system, providers can enhance their financial stability while improving patient satisfaction and care efficiency.

Description

Effective collaboration in patient care hinges on continuous connectivity and access to the latest information. It has become increasingly crucial to streamline the exchange of this information with insurers. Availity simplifies the process of working with payers, guiding you from the initial verification of a patient's eligibility to the final resolution of reimbursements. Clinicians desire quick and straightforward access to health plan details. With Availity Essentials, a complimentary solution backed by health plans, providers can benefit from real-time data exchanges with numerous payers they frequently engage with. Additionally, Availity offers a premium option known as Availity Essentials Pro, which aims to improve revenue cycle performance, minimize claim denials, and secure patient payments more effectively. By relying on Availity as your trusted source for payer information, you can dedicate your attention to delivering quality patient care. Their electronic data interchange (EDI) clearinghouse and API solutions enable providers to seamlessly integrate HIPAA transactions along with other essential functionalities into their practice management systems, ultimately enhancing operational efficiency. This comprehensive approach ensures that healthcare providers can maintain focus on their primary mission: patient well-being.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

AZZLY No 
AbbaDox No 
Accurint Crime Analysis No 
Cohere Unify No 
EZBIS No 
ElderSuite No 
InMyTeam No 
InvisaClaim No 
Juris No 
Lexis Advance Quicklaw No 
Lexis Omni No 
Lexis PSL No 
Motileo No 
Motivity No 
Nexis Data+ No 
Nexis Diligence No 
Nexis Dossier No 
VerifyRX No 
Vetriq No 
Visualfiles No 

Integrations

AZZLY Yes 
AbbaDox Yes 
Accurint Crime Analysis Yes 
Cohere Unify Yes 
EZBIS Yes 
ElderSuite Yes 
InMyTeam Yes 
InvisaClaim Yes 
Juris Yes 
Lexis Advance Quicklaw Yes 
Lexis Omni Yes 
Lexis PSL Yes 
Motileo Yes 
Motivity Yes 
Nexis Data+ Yes 
Nexis Diligence Yes 
Nexis Dossier Yes 
VerifyRX Yes 
Vetriq Yes 
Visualfiles Yes 

Pricing Details

$1039.00/one-time/user
Free Trial No 
Free Version No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Customer Support

Business Hours No 
Live Rep (24/7) No 
Online Support Yes 

Types of Training

Training Docs Yes 
Webinars No 
Live Training (Online) Yes 
In Person Yes 

Types of Training

Training Docs No 
Webinars Yes 
Live Training (Online) Yes 
In Person No 

Vendor Details

Company Name

Vālenz

Founded

2004

Country

United States

Website

www.valenzhealth.com/valenz-assurance/abn-assistant/

Vendor Details

Company Name

Availity

Country

United States

Website

www.availity.com

Product Features

Medical Billing

Claims Processing No 
Claims Scrubbing No 
Code & Charge Entry No 
Compliance Tracking Yes 
Customizable Dashboard Yes 
Dunning Management Yes 
Invoice History Yes 
Patient Eligibility Checks No 
Practice Management No 
Quotes/Estimates Yes 
Remittance Advice Yes 

Product Features

Hospital Management

Accounting Integration Yes 
Appointment Management No 
Appointment Scheduling Yes 
Bed Management No 
Billing & Invoicing Yes 
Claims Management Yes 
In-Patient Management Yes 
Inventory Management No 
Medical Billing Yes 
Out-Patient Management Yes 
Patient Records Management No 
Physician Management No 
Policy Management No 
Revenue Management No 

Medical Billing

Claims Processing No 
Claims Scrubbing No 
Code & Charge Entry No 
Compliance Tracking No 
Customizable Dashboard No 
Dunning Management No 
Invoice History No 
Patient Eligibility Checks No 
Practice Management No 
Quotes/Estimates No 
Remittance Advice No 

Revenue Cycle Management

Accounts Receivable No 
Claims Management No 
Collections Management No 
EHR/EMR Integration No 
For Healthcare No 
ICD-10 Compliance No 
Insurance Verification No 
Medical Billing No 
Patient Portal No 
Patient Registration No 
Patient Scheduling No 
Payment Processing No 

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