Average Ratings 0 Ratings
Average Ratings 0 Ratings
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
Cohere assists health plans in transforming their processes by integrating clinical intelligence, which facilitates comprehensive automation of prior authorization internally. Health plans can license Cohere's PaaS for intelligent prior authorization directly, allowing their utilization management teams to utilize it seamlessly. Consequently, client health plans experience notable improvements in administrative efficiency, alongside enhanced patient outcomes that are both quicker and more effective. Cohere offers a customized, modular solution suite specifically designed for health plans, streamlining all prior authorization requests into a cohesive, automated workflow. The platform automates decisions regarding prior authorizations based on the policies preferred by the health plans and accelerates the manual review process. It also aids clinical reviewers in handling complex requests with the help of responsible AI/ML and its automated features. By harnessing clinical intelligence through AI/ML and sophisticated analytics, Cohere enhances the performance of utilization management. Furthermore, it contributes to improved patient and population health outcomes through innovative programs tailored to specific specialties. This comprehensive approach positions Cohere as a leader in the health technology space, ensuring that health plans can meet their operational goals effectively.
API Access
Has API
No
API Access
Has API
No
Integrations
No details available.
Integrations
No details available.
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
Yes
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
Yes
Webinars
Yes
Live Training (Online)
No
In Person
Yes
Vendor Details
Company Name
Vālenz
Founded
2004
Country
United States
Website
www.valenzhealth.com/valenz-assurance/abn-assistant/
Vendor Details
Company Name
Cohere Health
Country
United States
Website
coherehealth.com/paas
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