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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

Prioritizing the front end is essential for enhancing the overall patient financial experience and optimizing revenue cycle outcomes. By implementing cohesive front-end solutions, organizations can effectively address deliverability issues, significantly reducing the occurrence of returned mail and unpaid invoices. It is crucial to minimize input errors by accurately verifying patient identity and demographic details. Additionally, confirming insurance eligibility at the point of service plays a vital role in maximizing revenue while ensuring compliance with regulations. To streamline processes, automating prior authorization from start to finish within seconds can lead to improved efficiency. Furthermore, automating notifications guarantees that payers receive timely updates regarding inpatient hospital admissions. Clear and precise communication of patient out-of-pocket expenses also contributes to better financial transparency. By assessing patients' propensity to pay and their eligibility for financial assistance, hospitals can enhance their collections. Once a secondary concern, patient access is now recognized as a pivotal element in healthcare facilities. Our adaptable platform harnesses the power of integrated data from various verification sources, coupled with intelligent guidance, to create a comprehensive solution. This integration not only fosters better patient access but also drives overall organizational effectiveness.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

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) Yes 
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) Yes 
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

SSI Group

Country

United States

Website

thessigroup.com/access-management/

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

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