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
InvisaClaim stands out as the premier all-in-one revenue platform, leveraging AI to enhance Revenue Cycle Management by streamlining denial management, appeals, prior authorizations, and compliance with the No Surprises Act for billing companies and RCM teams. Users can upload or utilize a live feed to submit denial letters or 835 ERAs, allowing the AI to swiftly extract essential patient information, CARC/RARC codes, CPT/ICD-10 codes, amounts, and deadlines, subsequently generating tailor-made appeal letters for over 30 payers in just one minute.
The system comprises various modules, including a Denial Workbench, NSA/IDR for eligibility verification and QPA capture, Prior Authorization, Pre-Check AI, A/R aging, NPPES NPI verification, deadline alerts, and a comprehensive audit trail. In addition, InvisaClaim seamlessly connects with your clearinghouse and EHR systems, boasting integration partnerships with notable entities such as Change Healthcare/Optum for features like ERA, eligibility checks, claim status, and prior authorizations, while Availity integration is currently underway and Waystar facilitates Provider Access Requests.
Furthermore, strategic EHR collaborations with Athenahealth are in the works, alongside the implementation of a FHIR R4 layer for interoperability with Epic and Cerner systems, ensuring a robust and flexible service. With a commitment to security, InvisaClaim adheres to HIPAA compliance and holds SOC2 certification, demonstrating its dedication to maintaining the highest industry standards.
API Access
Has API
No
API Access
Has API
No
Integrations
Authorize.Net
No
Availity
No
Change Healthcare
No
Change Healthcare Data & Analytics
No
Chase Merchant Services
No
Docusign
No
EpicCare EMR
No
Optum AI Marketplace
No
Optum Patient Care Management
No
Oracle Health
No
Integrations
Authorize.Net
Yes
Availity
Yes
Change Healthcare
Yes
Change Healthcare Data & Analytics
Yes
Chase Merchant Services
Yes
Docusign
Yes
EpicCare EMR
Yes
Optum AI Marketplace
Yes
Optum Patient Care Management
Yes
Oracle Health
Yes
Pricing Details
$1039.00/one-time/user
Free Trial
No
Free Version
No
Pricing Details
$349
Pricing starts at $349 per month per provider with tiers between $349-Enterprise.
Free Trial
Yes
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)
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
InvisaClaim, LLC
Founded
2026
Country
United States
Website
www.Invisaclaim.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
Medical Billing
Claims Processing
Yes
Claims Scrubbing
Yes
Code & Charge Entry
Yes
Compliance Tracking
Yes
Customizable Dashboard
Yes
Dunning Management
No
Invoice History
Yes
Patient Eligibility Checks
Yes
Practice Management
Yes
Quotes/Estimates
Yes
Remittance Advice
Yes
Revenue Cycle Management
Accounts Receivable
Yes
Claims Management
Yes
Collections Management
Yes
EHR/EMR Integration
Yes
For Healthcare
Yes
ICD-10 Compliance
Yes
Insurance Verification
Yes
Medical Billing
Yes
Patient Portal
Yes
Patient Registration
Yes
Patient Scheduling
Yes
Payment Processing
Yes