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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
Payers and provider networks that encompass over 10 million patients have successfully overseen 200,000 transitions in care using ReferWell. This platform enhances Medicare Advantage offerings, elevates member satisfaction, and facilitates the closure of care gaps to drive quality improvements. It also works to bolster network adequacy across various electronic medical records (EMRs), while simultaneously minimizing expensive transitions and preventing revenue leakage. By enhancing access to care and uncovering new revenue opportunities through the 340B program, ReferWell aims to support community health initiatives. Additionally, the solution helps to fortify partnerships with local providers, ensuring that patient referrals are directed to appropriate hospital specialists, thus further reducing financial losses. Fully compliant with HIPAA regulations, ReferWell seamlessly integrates with leading EMRs and scheduling systems, promoting efficient clinical data sharing among providers and improving care coordination without the delays associated with traditional communication methods. Supporting all integration protocols, the ReferWell system empowers provider networks to effectively manage patient and member care transitions while maintaining comprehensive oversight of patient and provider interactions. This innovative approach not only streamlines processes but also enhances the overall quality of care provided to patients.
API Access
Has API
API Access
Has API
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
ReferWell
Country
United States
Website
public.referwell.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