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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
MedArise serves as an AI-driven back office solution tailored for medical practices, managing and overseeing AI workflows that comprehensively address specific administrative tasks from beginning to end. This includes handling prior authorizations, verifying insurance eligibility, processing referrals and faxes, following up on claims status, and overseeing revenue cycle operations. By integrating seamlessly with a practice’s existing systems, MedArise ensures that exceptions are directed to human staff for resolution rather than being obscured. Importantly, clinical judgment, assessments of medical necessity, coding decisions, financial authority, and deviations from practice policies are entrusted to qualified personnel. Practices have the flexibility to initiate with a single, well-defined workflow, assess its performance and supporting evidence, and only expand once they have confirmed that the workflow is functioning reliably and efficiently. This approach not only enhances operational efficiency but also maintains the high standards of care that patients expect.
API Access
Has API
API Access
Has API
Screenshots View All
No images available
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
MedArise
Website
medarise.com
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