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Description
Match Score
Clients
Product Capabilities
Use cases
EHR integrations
Product attributes
Differentiators
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Company details
Jump to:
Categories
Solutions
Description
Match Score
Clients
Product Capabilities
Use cases
EHR integrations
Product attributes
Differentiators
Keywords
Media
Company details
Provider Referral Management
Provider Referral Management

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Categories

Solutions

Referral Management Software Solutions

Robotic Process Automation Platforms

Referral Management Software Solutions

Medical Benefit Prior Authorization Tools

Description

Product Description:
Provider to Provider referrals for employed and affiliated providers.
About MD Insider:
MD Insider is a healthcare solution partner that is redefining the way consumers search for care by democratizing clinical insights through data and technology. Our sophisticated Machine Learning (ML) platform is a first-of-its-kind, fully integrated triage engine that better matches patients with the right providers by incorporating a claims-driven methodology. MDI offers a variety of configurable digital applications that enable a seamless consumer experience across patient access channels, in addition to an industry-leading claims library, and API services. For more information please visit: www.mdinsider.com
Product Description:
VALER is a cloud-based **Enterprise Authorization Platform** that streamlines and automates today's manual authorization workflows. VALER provides **ONE place to SUBMIT and VERIFY authorizations across all payors and all services types** (professional, facility, ancillary, medications, etc). VALER is the only solution that manages authorization submissions for both payor **FAX** and **web portal** based workflows. VALER provides enterprise-wide visibility on **real-time authorization status** and documentation to eliminate duplicate work and support the revenue cycle.
About Voluware:
Voluware provides innovative, cloud-based workflow optimization and automation solutions for administrative healthcare transactions. Our VALER platform streamlines and automates prior authorizations, eligibility verification, and referrals document management in one, easy-to-use workspace. VALER eliminates paper fax and integrates with payer web portals to automate prior authorizations. VALER improves office staff productivity and reduces the cost of managing prior authorizations. VALER eliminates manual data entry errors with prior authorizations that impact the revenue cycle. VALER delivers the benefit of automated electronic transactions today with zero client installs and zero interoperability requirements.

Match score

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Clients

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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 maintains both historical data on actual authorization requirements (clinical data and relevant provider, facility data) and has the ability to implement highly targeted business rules to avoid unecessary errors and denials.

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:

None provided

COVID-19 use cases:

None provided

Pediatric use cases:

None provided

Users:
Contact Center agents, Providers, Clinical support staff (e.g. receptionist, CNAs, patient scheduling coordinators).
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.

COVID-19 use cases:

None provided

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

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

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

Hardware Compatibility:

Desktop

Product Attributes

badge_Covid-19

Covid-19

badge_Pediatric

Pediatric

badge_Covid-19

Covid-19

badge_Pediatric

Pediatric

Differentiators

Differentiators vs EHR Functionality:
A consumer-centric/robust clinical search engine that sits on top of a12B+ claim library representing medical claims across major carriers (commercial & CMS). Claims are used to inform provider clinical experience/expertise for employed and affiliated providers across a health systems network.
Differentiators vs Competitors:
Access to claims data for 95% of physicians nationwide (~1.1M physicians), proprietary quality outcome & experience metrics (optional), configurable search taxonomy.
Differentiators vs EHR Functionality:

VALER provides comprehensive coverage of **all payor authorization workflows (fax, phone, web portals) ** and rapidly updates new or changing authorization requirements.

VALER serves as a **single point of integration** and maintains changing requirements for all payor authorization workflows across fax, phone, and web portals.

VALER flexibly integrates with EHRs and practice management systems to reduce manual data entry and scanning of documents

Differentiators vs Competitors:

VALER streamlines and automates today's highly manual **AUTHORIZATION SUBMISSION** and **VERIFICATION** workflows with proven results of 45% reduction in staff time and 11% improvement in staff productivity.

VALER covers **all service types** including professional, facility, technical, medications, and DME authorization workflows
VALER provides **real-time data** on authorization processing times, staff productivity, payor behaviors/turnaround time to optimize prior authorization workflows VALER allows for **coordination and collaboration across the enterprise** to reduce duplicate work and errors between ambulatory clinics, facility admitting/scheduling, and the revenue cycle teams.   

VALER promotes **clean claims** by **standardizing** and **streamlining** authorization submission by injecting **payer rules** in the workflow to reduce costly denials

Keywords

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Downloads

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Company Details

Founded in 2012

Founded in 2010

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