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ease
features
design
support

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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

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

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

$1039.00/one-time/user
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

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
Claims Scrubbing
Code & Charge Entry
Compliance Tracking
Customizable Dashboard
Dunning Management
Invoice History
Patient Eligibility Checks
Practice Management
Quotes/Estimates
Remittance Advice

Product Features

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