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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
Prior Authorization
Prior Authorization

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Categories

Solutions

Description

Product Description:
  • Janus Health Prior Authorization supports the full auth process, from determination to statusing.
  • Seamless EHR integration enables your team to operate within their established workflows, maximizing efficiency and boosting employee satisfaction. Intelligent automations allow staff to avoid unnecessary follow-up, working only those auths that demand attention. Plus, cover more of your specialties like radiology, cardiology, surgery, and more, across ~80% of your payer mix.
  • Experience enhanced operational efficiencies that support employee retention, save valuable staff time, and reduce authorization-related denials, increasing revenue and reducing cost-to-collect.

About Janus Health:

Janus Health is fundamentally transforming the future of revenue cycle work with our groundbreaking end-to-end artificial intelligence platform. Our rich history in healthcare and technology allows us to instinctively understand what it is about revenue cycle management that creates significant challenges for healthcare organizations. We’ve developed Operational Intelligence and Intelligent Automation solutions to aid revenue cycle teams in optimizing their workflows, so they can do more with less and ultimately collect more cash.

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

An unattended automation is initiated from the EHR, determines whether an auth is required, and returns the response to the EHR. From there a user can initiate the submission workflow, if needed.

We leverage real-time automations instead of relying on a quickly outdated rule library, allowing us to keep up with the payer landscape and prior authorization changes. We can develop some client-specific rules per automation.

Leveraging Janus Health Teleport, Prior Authorization automates navigation to the authorizing payer or portal to the point where human intervention (clinical documentation upload and submission) is required.

An unattended automation checks the status of submitted authorizations and returns it to the EHR.

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:

Prior Authorization automates auth determination at scheduling, so patient access staff only touches those accounts requiring authorization submission.

Pediatric use cases:

None provided

Users:

Patient access specialist

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

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

Differentiators

Differentiators vs EHR Functionality:
  • Broad payer and specialty coverage, driven by providers' needs (not payer sponsorship)
  • >80% of payer mix
  • Teleport streamlines auth initiation
Differentiators vs Competitors:
  • Broad payer and specialty coverage, driven by providers' needs (not payer sponsorship)
  • >80% of payer mix
  • Teleport streamlines auth initiation
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

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Downloads

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OHSU Case Study.pdf

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Company Details

Founded in 2010

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