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Description
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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
HIP One
HIP One

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Categories

Solutions

Description

Product Description:
HIP One harnesses advanced AI and GenAI capabilities, enhancing the productivity of clinical and business operations teams by an impressive 30-50%. The platform’s built-in security, privacy, and compliance ensures that innovation is delivered responsibly and in full adherence to industry standards. By delivering comprehensive, integrated solutions, HIP One eliminates the need for building point-specific tools. That’s because each module within HIP One is purpose-built to address multiple use cases, including: Prior Authorization (PA) Utilization Management (UM) Case management (CM) Medical Reviews
About Genzeon:

We are Genzeon—your trusted partner in healthcare transformation, delivering AI-powered solutions, seamless data integration, and technology that drives better outcomes.

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

HIP One is Genzeon’s AI-powered healthcare platform, designed to seamlessly integrate core business processes and clinical workflows on a single, intelligent platform. By eliminating manual workarounds and disjointed point solutions, HIP One delivers enterprise-wide efficiency, accuracy, and enhanced decision support for payers, providers, and healthcare organizations.

The platform’s built-in security, privacy, and compliance ensures that innovation is delivered responsibly and in full adherence to industry standards.

HIP One delivers enterprise-wide efficiency, accuracy, and enhanced decision support for payers, providers, and healthcare organizations.

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:

Medical reviewers, nursing staff, and clinicians are required to examine medical records for claims and verify patient data related to prior authorizations and claims, also respond to specific questionnaires associated with each claim. Currently, this process is conducted manually, where they meticulously scrutinize each document to verify its accuracy and provide responses to the questionnaire. To assist in their assessments, they refer to both the provided claim document and the CMS document. Subsequently, based on their findings and responses to the questionnaire, they make recommendations regarding the claim as approval, denial or requesting further information. The duration of this entire process varies from a few hours to several days, depending on the number of pages in each document. 

Our medical review solution, developed with the assistance of GenAI, streamlines this process by employing an LLM to automatically respond to questionnaires. This solution helps the nursing staff to improve their productivity by 30-50% by automating the review of medical records. 

Pediatric use cases:

None provided

Users:

Anonymous nationwide payer client

Government payer entity

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, ERP system, Pop health platform, Access +/or revenue cycle, Credentialing

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic, Cerner, Allscripts

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:

Built by domain experts in specific claim and prior authorization types

Differentiators vs Competitors:

Flexible commerical structure

Platform capability vs point solution

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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HIP One - Short Demo

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Valer Explainer Video_Final.mp4

Downloads

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HIP One Sales Sheet
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VALE144-Glossary_v7.pdf

Alternatives

Company Details

Founded in 2010

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