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

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Categories

Solutions

Description

Product Description:

Establish Networks
Our data ingestion platform can consume internal and external claims, quality data, and other relevant insights such as patient access or provider loyalty data that allow you to then rank specialists and facilities using a custom weighting method by service line. Our clients leverage this intelligence to build custom referral networks. Examples include a network for value-based care, an owned provider network, an affiliated network, or building networks for community-based resources.

Auto IdealMATCH
Leverage Network Intelligence data at the time of referral. Coordinators are prompted to select the most appropriate specialist for the patient based on insurance, quality outcomes, costs, location, and patient preferences. IdealMATCH is integrated into Epic so it doesn’t disrupt the existing workflow.

Auto Prior Authorizations & Scheduling
ReferralPoint is able to automate a large portion of the referral notification and prior authorization process then enables automated scheduling capabilities based on the workflow of the practice (by patient, by staff, in real-time).

Auto Closing the Loop
ReferralPoint supports closing the patient care loop between the primary care provider and specialist while tracking each step from referral order to a closed loop regardless of the referred-to providers EHR. Once a referral option is selected, ReferralPoint automates communication (SARA) with the patient to guide them along the journey then updates the status of each referral - including automated reminders, follow up, and even feedback surveys which can be used to update the scores of each provider. Because our solution is built on a data ingestion engine, we can close the referral loop a number of ways including engaging the patient, faxing the specialist, analyzing claims or receiving ADT feeds.

About ReferralPoint:

ReferralPoint is the leading expert in referral management solutions for health systems, medical groups, and payers looking to reduce leakage, increase revenue and savings, improve efficiency, and enhance patient satisfaction. ReferralPoint uses data and automation to alleviate staffing challenges while supporting fee-for-service and value-based care initiatives.

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 Valer:

Valer 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.

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 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:

Ideal partners look to automate, streamline, and track outbound referral processes for [de]centralized referral/care coordination teams all from within EHR workflows.

Pediatric use cases:

None provided

Users:

ACOs, CINs, Payers, Health Systems, FQHCs, Provider Groups

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:

Acute care EMR, Ambulatory EMR, Ancillary EMR, Pop health platform, Community based organizations, ADT

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Athenahealth, NextGen, Allscripts, GE, eClinicalWorks, Meditech, 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

Hardware Compatibility:

Desktop

Client Types

Differentiators

Differentiators vs EHR Functionality:

We ingest your patients, claims, and 3rd party data

Differentiators vs Competitors:

More than just a referral app...we're a Data Driven, Fully Automated, Referral Strategy Platform that allows you to:  

1. Analyze Referral Trends over three year look-back to reduce leakage, cost, improve care quality and patient experience

2. Optimize Preferred Networks with provider scoring, patient-provider matching, and actionable insights into gaps and opportunities

3. Automate Referral Workflows with provider selection, scheduling, patient communication, and closing the loop all from within your existing EHR workflow

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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Data-driven, fully automated, closed-loop referral management

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Company Details

Founded in 2010

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