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

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Categories

Solutions

Description

Product Description:
eviCore intelliPath® is eviCore’s electronic prior authorization solution housing a suite of capabilities that simplify and automate the prior authorization process. These capabilities include connectivity, real-time decisions, case validation, and simplified clinical surveys. eviCore intelliPath® is deployed by provider organizations to automate and simplify submitting and tracking requests for prior authorization. eviCore intelliPath® streamlines operations within a single easy-to-use application that integrates with major electronic health record (EHR) vendors. Provider costs are reduced and decisions are communicated in real time, reducing delays.
About EviCore by Evernorth:

eviCore healthcare offers proven, diversified medical benefit management solutions that help clients reduce costs while increasing quality of care for their members. The company provides these solutions to managed care organizations and risk-bearing provider organizations serving commercial, Medicare and Medicaid populations. Powered by a team of specialized medical professional resources, extensive evidence-based guidelines and advanced technologies, the company supports clients by ensuring the right evidence-based care is delivered at the right time to the right patient at the right site of care.

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.

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:
  • Lower costs for healthcare-delivery organizations
  • Reduced frustration and more transparency for patients and clinicians
  • Better network relationships for health plans
Pediatric use cases:

None provided

Users:

Patients, Providers, Payers

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

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

Epic

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, GE, Athenahealth, Other

Hardware Compatibility:

Desktop

Client Types

None provided

Differentiators

Differentiators vs EHR Functionality:

eviCore intelliPath® is eviCore’s electronic prior authorization solution housing a suite of capabilities that simplify and automate the prior authorization process. These capabilities include connectivity, real-time decisions, case validation, and simplified clinical surveys.

eviCore intelliPath® is deployed by provider organizations to automate and simplify submitting and tracking requests for prior authorization. eviCore intelliPath® streamlines operations within a single easy-to-use application that integrates with major electronic health record (EHR) vendors. Provider costs are reduced and decisions are communicated in real time, reducing delays.

Differentiators vs Competitors:

Administrative Cost Savings

eviCore’s medical benefits management solutions are proven to reduce unnecessary–and potentially harmful–tests and procedures. But securing prior authorization can impose a high burden on provider organizations; for example, dedicated administrative staff are hired to request and track cases, and clinicians typically must allocate time to provide details on the patient’s medical diagnosis.

In place of implementing an abundance of tools, multiple health plan portals, and time-consuming manual interactions, eviCore intelliPath® simplifies and streamlines prior authorization operations with a single, integrated application. eviCore intelliPath® leverages the substantial investment in EMRs on the part of provider networks. It automatically incorporates case details from the patient’s chart and fits seamlessly into clinical and revenue cycle workflows.

Clinical Efficiency

Further, eviCore intelliPath® integrates with eviCore’s utilization management system (and those of other UM providers). This speeds communication of critical information (e.g., automated approval, no prior authorization required, or additional clinical information is needed for a decision to be made). With the approval or denial in hand, patients can be scheduled or alternative tests or procedures ordered in a timely fashion.

Benefits for Patients, Providers, and Health Plans

  • Lower costs for healthcare-delivery organizations
  • Reduced frustration and more transparency for patients and clinicians
  • Better network relationships for health plans
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

Keywords

Images

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Videos

No videos provided

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Valer Explainer Video_Final.mp4

Downloads

https://www.evicore.com/insights/global-shortage-of-iodinated-contrast-media
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VALE144-Glossary_v7.pdf

Alternatives

Company Details

Founded in 1994

Founded in 2010

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