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
The Cohere Unify platform enhances all of our intelligent prior authorization solutions through the integration of touchless and predictive technologies, clinical content grounded in evidence, and various advanced features. By leveraging these technologies, we significantly minimize or completely remove the manual processes involved in achieving a comprehensive, fully automated prior authorization workflow. This predictive functionality allows health plans to nearly eradicate the traditional steps associated with prior authorization processes. Consequently, the system can autonomously generate tailored care plans utilizing patient and population authorization and claims data, which includes the ability to pre-approve multiple services before any requests are made. We employ evidence-based clinical criteria for specific specialties that complement our touchless and predictive technologies. Additionally, our platform features reliable single sign-on capabilities with widely used portals such as Availity and NaviNet. Furthermore, the configuration and implementation of rules have been validated to effectively manage transactions involving millions of cases, showcasing the scalability of our system. Ultimately, this innovative approach streamlines healthcare operations while enhancing efficiency and accuracy.
API Access
Has API
No
API Access
Has API
No
Integrations
Availity
No
NaviNet Open
No
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/unify-platform
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