Vālenz® Health MEC Solution
An open-access, non-contracted network solution complete with assured payment options for minimum essential coverage (MEC) plans
Valenz MEC Solution, the industry-recognized Assured Payment solution, offers employers an open-access, non-contracted network solution, complete with assured payment options for MEC plans. With this innovative approach, you can improve access to quality care, achieve 50-75% cost improvement, and minimize member disruption or provider friction for the vast majority of your claims.
Reduced cost, data-rich solution
The Valenz MEC Solution combines with your health benefits plan to extend favorable reimbursement for MEC plans under the Affordable Care Act (ACA). Unlike traditional MEC network offerings, Valenz MEC Solution enables members to choose high-quality medical providers and facilities to meet their precise health needs, while balancing the financial cost for the member, the plan and the provider. It’s a win-win: Members gain open choice to select higher-quality care for fair and reasonable costs (including lower out-of-pocket expenses), and providers receive reimbursement based on fair, acceptable, market-recognized pricing and geography.
Unlike health plans that offer a specific network (for example, a PPO), Valenz MEC Solution allows members to seek care and treatment for covered services under the plan from any provider. While providers and facilities are not considered “in network,” they are granted favorable rates as a part of their reimbursement agreements.
A whole new level of transparency for lower costs and healthier lives
To deliver fair, defensible, consistent pricing, we use reliable, algorithmic decision-making powered by a proprietary repricing methodology that blends payment costs and market-specific, charge-based data sets. Leveraging the strength of the fully integrated Valenz platform, we drive high-value, non-contracted network solutions, direction of care and high-quality provider utilization. For everything under the Claim Cost ArcSM – from pre-claim decisions to post-claim resolutions – Valenz engages early and often for smarter, better, faster healthcare.
For more insight into the benefits and impact of this solution for members and providers, visit the FAQs below:
Improve cost, quality, member experiences and provider-payer relationships
The Valenz MEC Solution delivers many advantages for all stakeholders:
- Non-contracted solution to replace wrap networks
- Access to high-quality medical providers and facilities at fair, reasonable costs
- Lower member out-of-pocket costs
- Providers reimbursed based on fair, acceptable, market-recognized pricing and geography
- Minimizes risk of balance billing
- Assured payment for majority of claims
- Savings improvement of 50-75%
- Full-service claim management
