Avia Logo

Compare Products


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

Powered by advanced AI and machine learning, Care Continuity’s Specialty Referral Optimization solution allows hospitals and health systems to better prioritize the patients for navigation based on their clinical needs as well as their likelihood to engage and accept navigational assistance, leading to more effective and efficient patient navigation teams.

When a specialist referral is initiated, our Navigator Predict ingests information about the referral, including the clinical history and demographics, as well as details of the health system’s network dynamics and objectives (e.g., social determinants of health, readmission risks, service line capacity, etc.) 

 

The referral details are combined with more than 50 weighted navigation variables to prioritize patiens for navigation and to curate a navigational pathway customized for each patient's care journey.  

Our software is supported by a team of trained patient navigators that do the navigating on your behalf or complement your inhouse team of navigators if needed.

Finally, we provide curated data dashboards provide key insights into the strength of your provider network giving actionable insights into appointment logjams, leakage/outmigration points, and opportunities for improvement.

About Care Continuity:

Founded in 2014, Care Continuity provides expert patient navigation solutions that are designed to bridge gaps in healthcare, providing seamless transitions between care settings, reducing network leakage, and promoting optimal health outcomes and patient satisfaction. Through a combination of advanced software, AI and a dedicated team of care concierges, we help guide patients through their care journey while maintaining the integrity of the health system network. This translates to greater patient satisfaction, better health outcomes, and increased margins for our clients.

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:

Leveraging AI & machine learning allows us to prioritize which patients to contact first based on their predicted

utilization patterns, potential for necessary downstream procedures, and the increased need for specialty care. Through prioritized engagement and outreach, 90% of patients needing a new PCP are getting their next appointment scheduled within seven days of discharge. 

By prioritizing the patients with greatest need, we’ve seen a 25% reduction in median time to appointment for new specialist relationships. Patients with the highest likelihood of needing downstream high-margin procedures were all seen within 14 days of discharge.

Streamlining how we priortize patients for navigation also results in improvements in throughput and capacity. By applying smarter, iterative models, one client has seen a 90%

growth in patient visits (and double the profit margin), 142% more visits than would have occurred without navigator intervention and 3x the volume of same day surgeries, resulting in an increase in higher margin procedures.

Pediatric use cases:

None provided

Users:

Medium to extra-large health systems

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:

Acute care EMR, Ambulatory EMR, Ancillary EMR, ERP system, Patient portal, Pop health platform

EMR Integration & Relevant Hardware:

Required

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson

Hardware Compatibility:

Not applicable

Client Types

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:

Leading EHR functionality takes a very basic approach to patient navigation. When utilized, the EHR prioritization queue is binary, labeling every patient as urgent or non-urgent. Instead, Care Continuity not only expands the total number of evaluated data points needed to properly prioritize a patient, but Care Continuity also expands the priority listing to 10 levels, allowing for a more nuanced and tailored navigational experience. 

In addition, the EHR functionality requires the health system to staff a team of navigators. Unfortunately, this largely non-clinical function is staffed by clinical staff, severely hampering their ability to work at the top of their license. 

Care Continuity pairs their purpose-built software with a team of trained, non-clinical concierges who are experts in patient experience and proper navigation.

Differentiators vs Competitors:

With more than a decade of experience working with the nation's leading health systems, Care Continuity has had the honor of navigating millions of patients through the healthcare continuum. 

Leveraging purpose-built software with proprietary algorithms designed to efficiently navigation patients, Care Continuity can provide a customizable, high-ROI solution for health systems of any size.

Keywords

Images

1 of 3

edit-media
Valer Reporting Screen Shot.png

1 of 6

edit-media
Sample Referral Dashboard

Videos

1 of 2

Valer Explainer Video_Final.mp4

No videos provided

Downloads

media thumbnail
VALE144-Glossary_v7.pdf
media thumbnail
Care Traffic Control for Your Health System

Alternatives

Company Details

Founded in 2010

Founded in 2008

Need help narrowing down products?

Add more criteria to see your compatibility level for every vendor. It only takes a few minutes, just create a free account to get started.
back to top