Valer

Some re-introductions are in order! Today, we’re thrilled to officially announce our rebrand from Voluware to Valer®, taking the name of our industry-leading #PriorAuthorizations and #ReferralManagement solution. This evolution accompanies a new era of company growth, product innovation, partnership expansion, enhanced client service, and more. While there’s a good bit of change ahead, Valer will continue to be the gold standard for automating complex manual prior auth workflows. We’re really excited about this next chapter for our clients, partners, and team. Learn more in our latest press release (and take a look around the new website!): https://hubs.la/Q02gBCZk0

Sky Lakes Medical Center was looking for a “magic button” when considering automation solutions for its referral management processes. Luckily, Valer was there to help. Hear from DeDe Spicher, Medical Clinic Supervisor at Sky Lakes, as she discusses how the solution works within its Epic workflows and notifies administrative staff along the full lifecycle of a claim.

A recent POLITICO piece provides insight into the House Task Force on AI, which turned its attention to the California law regulating how AI is used by insurers analyzing prior auths. Historically, insurers have used AI to streamline the process of reviewing prior auth requests, but there have been concerns around wrongful denials. The task force will keep its eye on the California law to see how it impacts costs and denial rates and consider introducing legislation to mirror the bill. To read more, follow this link: https://hubs.la/Q02-Z74K0

A recent article from the American Medical Association details the status of the Improving Seniors’ Timely Access to Care Act. A majority of the members of the U.S. House of Representatives have co-sponsored the bill, which seeks to reduce delays, streamline approvals, and eliminate outdated processes like faxes—ensuring patients get the care they need without unnecessary hurdles. Widespread support for the bill is a critical step toward modernizing prior authorization in Medicare Advantage. At Valer, we’re encouraged by the act’s focus on real-time decision-making and transparency. Learn more about the act here: https://hubs.la/Q02ZK4gz0

Hoping to get buy in for integrating automation into your prior authorization processes? Start by gathering impressive automation results from health systems like Kern Medical. Hear from Amber Teves, Manager of Front End Revenue Cycle at Kern Medical, as she describes how the organization went from an auth complete rate of 69% to 94% by using Valer.

Happy Thanksgiving from our team at Valer! We’re wishing you a healthy and safe holiday spent with family and friends.

In case you missed it, our most recent webinar with The Wilshire Group can be watched on demand now! Learn more about how tracking progress against best practice KPIs allows healthcare organizations to optimize operational results and support negotiations with payers about performance and reimbursement. Watch the webinar here: https://hubs.la/Q02Zln740

In a recent HIT Consultant Media piece, Valer CEO, Dr. Steve Kim, detailed his experience with prior authorization challenges as a pediatric physician and how recent legislations may impact insurance plans. He shared his perspective on the Improving Seniors’ Timely Access to Care Act, which seeks to streamline the approval process for Medicare Advantage plans, reduce administrative burdens for healthcare providers, and ensure patients receive timely access to necessary medical treatments. Read the full piece here: https://hubs.la/Q02Zln710

Don’t miss today’s webinar session with The Wilshire Group! Attendees will learn how tracking the right performance metrics can transform prior authorization process, improve operational efficiency, and strengthen payer-provider relationships. Key Highlights: • Identifying Pain Points: Discover the common challenges health systems face with prior authorization. • Key Metrics for Success: Learn which KPIs, including turnaround time, approval rates, and accuracy, are critical for optimizing staff and payer performance. • Benchmarking Against Industry Standards: Understand where your organization stands and the key metrics you should be tracking. • How Automation Supports KPIs: Learn how prior authorization automation can improve workflows, resolve bottlenecks, and boost efficiency. Sign up now! https://hubs.la/Q02YvXgd0

Prior authorization has long been a source of frustration for patients and physicians, but the American Medical Association's recent policy adoption sends a clear message: “No more take backsies.” Insurers are increasingly requiring extensive documentation and approvals, only to retroactively deny or recoup payment after care has been delivered. This practice creates unnecessary administrative burdens, delays care, and places financial strain on practices and families. The AMA’s stance is if care is preauthorized or precertified, payment should be guaranteed—except in cases of fraud. By advocating for federal statutes to prohibit retrospective denials and supporting “gold card” programs to alleviate administrative strain, the AMA is fighting to ensure fair practices that prioritize patient care over bureaucracy. Learn more here: https://hubs.la/Q02YvW3N0