Best Insurance Eligibility Verification & Prior Authorization Products

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.

This solution automates the process of checking requests under review as well as continued status changes and updates. It supports many portals such as Evicore, Magellan, UHC and others. The solution includes business rules, exception handling and daily reporting functionality with customizable dashboard views. AI is also used to do analysis and supply predictive capabilities. The solution can also be hosted and supported by CampTek as an ongoing managed service.

Patient access departments are charged with accuracy from the start. 

Challenges—claims denials, returned mail, regulatory burdens and low patient satisfaction—are barriers they face. Solutions that empower registrars and staff with intuitive, consistent workflows and that prepare patients for their financial obligations have been elusive—until now.

True Access™ clearly and accurately fills the gaps in preservice coverage verification and estimation of patients’ financial obligations. Staff gain consistent workflows and patients receive precisely tailored payment options everywhere. True Access includes additional patient access tools for staff to support eligibility and address verification, medical necessity and prior authorization processes.

With True Access from RevSpring, you receive proven solutions that support four critical areas: 

(1) Coverage Determination and Verification,

(2) Claim Denial Prevention,

(3) Patient Financial Readiness and Increased

Collections, and

(4) Tools, Workflows and Reporting for Staff.

Coverage Determination & Verification

Fast, simple and accurate resolution of all patient accounts prior to, or at the point of, service—no matter whether or not patients are insured, uninsured, underinsured and/or qualify for financial assistance. Includes Eligibility, Coverage Verification and Determination, and Medicaid Coverage Discovery.

Claim Denial Prevention

True Access reduces time spent rebilling claims and reduces days in AR by submitting claims correctly from the start. Includes Prior Authorization and Precertification, Medical Necessity and Coordination of Benefits.

Patient Financial Readiness & Increased Collections

Prepare patients for their financial responsibility and empower them to pay precisely what they can, when they can, from anywhere. Accurate estimates, seamlessly 

integrated with RevSpring’s PersonaPay portal, enable patients to manage their balances with confidence. Our hassle-free billing adjustment solution also allows 

providers to confidently request payments in advance.

Tools, Workflows & Reporting for Staff

True Access empowers staff with intuitive workflows and a modern user interface to manage registration quickly and efficiently. Intuitive staff views based on work queues and guided workflows drive consistency and accuracy, saving time for patients and staff. Our tools also allow you to monitor staff performance.

Direct is the leading EHR-integrated cost transparency solution. The solution brings real-time, pharmacy benefit cost information, coverage restrictions, and alternatives into native EHR workflows. Giving providers cost information at the point-of-care enables data-driven and evidence-based decisions that help patients get the care they need at prices they can afford.

Features and Benefits:

 - Access to lower-cost alternatives increases care adherence and patient health and satisfaction

 - Select medications that do not require prior authorization

 - Reduced pharmacy/PBM/payer call-backs, prior authorization denials, and other uncompensated provider hassles

 - Uses native order workflows, is easy to implement

- Surfaces pharmacy alternatives to drive continuity of care and patient satisfaction

- Integrates patient affordability program offerings into RTPB results, showing best-cost options when insurance coverage isn't found or doesn't apply. 

Lose the work your heart's not in!

Whether you're a payer processing claims forms or a provider charting during your off hours, the administrative burden in healthcare is high. But when the work you want to do is buried under the work you have to do, don't lose heart.

Optimize your policy management.

The Most Comprehensive Database

Access the most complete database of live and historical medical and pharmaceutical policies and related documents on the market.

Real-Time Notifications

Stay ahead with email alerts on any changes to medical and pharmaceutical policies by payer and therapy, allowing you to respond swiftly to developments that may impact your stakeholders.

Central Access

Effortlessly search and review Medical & Pharmacy policies, draft policies, prior authorization documents, coding guidelines, reimbursement updates, and more—all in one centralized location.

Comparison View

Easily identify differences between current and historical versions using our intuitive viewer that highlights changes for quick reference.

Research Control

Focus your research by filtering specific payers, plan types, states, therapies, devices, or document types, ensuring you find exactly what you need.

Visit https://www.policyreporter.com/industry/providers/ for more information and a free trial.

DataMartrix Medical's prior authorization services are perfect for those practices backed up by the burden of prior authorizations and are not reimbursed promptly. We will handle PAs throughout the entire process. We can work alongside current staff to support orders, submissions, approvals, and the denial/appeal process or handle the whole process to free up time for you and your staff.

Our HIPAA-compliant and secure service is EHR and EMR agnostic, so we can work with any system with a minimum setup cost that is, on average, 70% less than AI-centered RCM tools and 50% less than an hourly employee. DataMatrix is 99+% accurate and offers 24/7 capabilities, so there is no downtime. The prior authorization service by DataMatrix Medical accommodates all private insurance, no-fault, and worker's comp.

For over 25 years, DataMatrix Medical has been a leader in healthcare business process support. The prior authorization product can work seamlessly with other products, such as medical scribing, document indexing, and medical credentialing.

Try the DataMatrix Medical prior authorizations service risk-free and no long-term contracts; cancel anytime.

Simplify Utilization Management between providers, members, and care management. Affinitē UM leverages Intelligent Automation to streamline administrative actions so your team can operate at the top of their licensure.

Offload repetitive admin tasks and increase patient engagement. Unlike current solutions that require manual calls and multiple vendor integrations, Infinitus captures comprehensive information quickly in one place.