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Solutions
Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Awards
Differentiators
Keywords
Media
Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Awards
Differentiators
Keywords
Media
Company details

Categories

Solutions

Description

Product Description:

Valer’s technology speeds and simplifies prior authorization and referral management by automating submissions, status checking, verification, reporting, and EHR synchronization across all mid-to-large sized healthcare settings, specialties, and payers from one platform and portal.

All built just for you.

About Valer:

Valer’s technology speeds and simplifies prior authorization and referral management by automating submissions, status checking, verification, reporting, and EHR synchronization across all mid-to-large sized healthcare settings, specialties, and payers from one platform and portal.

All built just for you.

Valer's automation technology enables our clients to reduce labor cost, claim denials from avoidable prior authorization errors, and writeoffs stemming from denials. With prior authorization approvals further in advance of scheduled treatments and procedures, Valer enables fewer rescheduled and abandoned appointments. Patients are happier, providers are happier, and staff are happier.

Product Description:
  • Cohere Unify™ Intake: Digitizing and improving intake across fax, EMR, and portal
  • Cohere Unify™ Decisioning: Prior authorization check, completeness scan, automated clinical review, and pended review pre-processing
  • Cohere Unify™ Review: Queue management, AI-assisted manual review, and letter generation

About Cohere Health:

Cohere Health is a clinical intelligence company that provides intelligent prior authorization as a springboard to better quality outcomes by aligning physicians and health plans on evidence-based care paths for the patient's entire care journey. Cohere's intelligent prior authorization solutions reduce administrative expenses while improving patient outcomes. The company is a winner of the TripleTree iAward and has been named to both Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists. Cohere's investors include Flare Capital Partners, Define Ventures, Deerfield, Polaris Partners, and Longitude Capital.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Product Capabilities

Valer can be configured to identify highly targeted information regarding authorization requirements and/or services which are "no auth required." Valer has the ability to work with select payers to provide authorization requirements, "no auth required" alerts, and authorization submissions via real-time APIs (application programming interfaces) where available.

Valer comprehensively automates completion and submission of prior authorizations for 1,000+ unique payer fax forms and 75+ payer web portals.

Valer's form library maintains and updates over 1,000+ payer authorization fax forms across all service lines (diagnostic imaging, surgeries, procedures, chemo/infusion, medications, notice of admissions, DMEs, sleep, Worker's Comp). Valer's proprietary technology can add any new fax form for users typically within 24 hours to support authorizations and referrals.

Valer provides the ability for users to easily attach any relevant clinical documentation to a prior authorization for submissions. Valer supports various file formats needed for submission. Valer also captures documentation from payers regarding approval tracking codes, expiration dates, units of service, CPTs approved, which can be pushed directly back into EHRs/practice management systems to avoid manual data entry. Valer also has Epic's x275 clinical document exchange functionality live in production to directly exchange information from Epic to Valer and back.

Valer comprehensively SUBMITS prior authorizations across both fax and web portal modalities across all-payers and all service types. Valer provides ONE interface, deeply integrated with EHR workflows to automate both today's manual authorization submission and verification workflows.

Valer provides automated authorization status verification across 75+ payer web portals. Authorization information (tracking numbers, units, expiration dates, sites of service, CPT/family of codes approved can be automatically pushed back into EHRs in an automated process further eliminating the need for manual data entry.

Use Cases

Description:

Valer provides health systems, hospitals, and ambulatory clinics with one place to streamline, automate, and manage today's manual prior authorization workflows. Valer saves time, cost, and reduces patient access denials and avoidable write-offs.

Pediatric use cases:

Pediatric health systems and clinics utilize Valer to reduce the time and cost involved with today's manual prior authorization and referral workflows.

Users:

patient access teams, ambulatory clinic authorization teams,  admitting/scheduling teams, revenue cycle teams

Description:
  1. Submit Prior Authorization
  2. Check Prior Authorization status
Pediatric use cases:

None provided

Users:
  1. Physicians
  2. Administrative staff
  3. Billing staff
  4. Nurse practitioner

EHR Integrations

Integrations:

Acute care EMR, Ambulatory EMR, Community based organizations, ADT, Access +/or revenue cycle, Website / public online sources

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic, Cerner, Allscripts, NextGen, athena, GE, Athenahealth, Other

Hardware Compatibility:

Desktop

Integrations:

Other

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic

Hardware Compatibility:

None provided

Client Types

Awards

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Differentiators

Differentiators vs EHR Functionality:
  • Single platform and payer portal consolidates payer management
  • Comprehensively submit, verify, manage prior authorizations and referrals
  • All payers and service lines
  • Continuous real-time payer updates
  • 2-way data integration with EHR systems
  • Real-time workflow visibility and reporting
  • Integrates with any EHR or billing system for seamless workflow
  • Clients using Epic, Cerner, Veradigm, Athenahealth, NextGen and more
Differentiators vs Competitors:
  • Valer focuses exclusively on automating submissions, status-checking, and verification with all payers- national, regional, local
  • Valer supports every service type, specialty, and care setting except formulary medications and dentistry
  • Valer integrated bi-directionally with any EHR or system of record
Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

The only UM platform designed to support in-house operations, or fully-delegated programs.

Whether a health plan is seeking to innovate their in-house UM operations or outsource utilizing a vendor partner for key service lines, Cohere is uniquely positioned to partner with them to build a path from digital transformation to true care collaboration.

  1. 25-40% reduction of administrative costs
  2. 65 NPS score among providers
  3. 70% faster access to patient care
  4. 15%+ medical cost savings beyond incumbent programs

Keywords

Images

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Valer Reporting Screen Shot.png

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Videos

1 of 2

Valer Explainer Video_Final.mp4

1 of 1

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Video: Cohere Unify

Downloads

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VALE144-Glossary_v7.pdf
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Cohere Health Overview

Alternatives

Company Details

Founded in 2010

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