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VALER Enterprise Authorization Platform
VALER Enterprise Authorization Platform
Overview
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Avia Summary
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VALER Enterprise Authorization Platform is a solution provided by Voluware which was founded in 2010. It belongs to multiple categories of digital health solutions including Care Transitions, Referral Management, Revenue Cycle Management, and Prior Authorization.
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It has 7 verified clients.
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VALER Enterprise Authorization Platform integrates with major EMRs such as Epic, Cerner, and Allscripts.
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Some other resource(s) that may be helpful in learning about VALER Enterprise Authorization Platform include: Q&A with Dr. Steve Kim of Voluware: A road map to the future of prior authorizations and Top Prior Authorization Companies Report | 2023
DESCRIPTION
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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.
Product capabilities
Requirements Identification
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.
AVIA GUIDEWhat is requirements identification?
Process to verify the necessity of submitting a prior authorization request is automated. If a prior authorization is required, solution can identify payer-specific rules.
Requirements Knowledge Base
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.
AVIA GUIDEWhat is requirements knowledge base?
Prior authorization requirements knowledge base is continually and automatically maintained. There should be minimal (if any) effort required of health systems to support this function.
Form Completion
VALER comprehensively automates completion and submission of prior authorizations for 1,000+ unique payer fax forms and 75+ payer web portals.
AVIA GUIDEWhat is form completion?
Prior authorization forms completion is augmented with automation, populating appropriate fields through leveraging structured and unstructured data from the EHR.
Forms Library
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.
AVIA GUIDEWhat is forms library?
Where necessary, payer-specific forms can be created/maintained.
Documentation Collection
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.
AVIA GUIDEWhat is documentation collection?
Necessary documentation can be attached to satisfy the prior authorization request.
Request Submission
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.
AVIA GUIDEWhat is request submission?
Prior authorization request can be submitted on behalf of the health system (through e-fax, payer portals, third party sites, etc.).
Status Monitoring
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.
AVIA GUIDEWhat is status monitoring?
Prior authorization request status is monitored in near real-time and can be pushed back, along with other relevant information (e.g., tracking numbers, supporting text), into the appropriate work queues and fields within the EHR.
EHR integration
Integrations
Acute care EMR, Ambulatory EMR, Community based organizations, ADT, Access +/or revenue cycle, Website / public online sources
EHR integration and relevant hardware
Recommended, but not required
EMRs supported
Epic, Cerner, Allscripts, NextGen, athena
Hardware compatibility
Desktop
Solution libraries
In Epic App Orchard: https://apporchard.epic.com/gallery/?id=1218Use cases and differentiators
Use case descriptions
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
Differentiators vs internal options
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
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December 1, 2023
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new review
December 1, 2023
Seeing increased results
Seeing what we're able to do bulk submission on or just touch once, now we can actually see reporting that shows us touch 1,100 of these authorizations a month once and never have to do anything on them again because it gets authorized and it gets pushed back into our system. We don't have to go out and check whether or not it's pending. We don't have to document the same thing that's in a portal somewhere into the EMR anymore. So we're seeing increased results...
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Ryanne Laurence
Assistant Director, End user working with VALER Enterprise Authorization Platform at Oregon Health and Science University Hospital
Review Source
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https://www.youtube.com/watch?v=xMjhdIRWQ5c&t=17s&ab_channel=Voluware
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