Our clinically-focused, data-driven analyses drive higher recoveries.

Valiant Health has been working with private and public healthcare payors to ensure accurate and appropriate reimbursement for over 40 years. Our payment integrity investigative staff includes nurses, physicians, and certified coders who review specific diagnoses categories for clients. As diagnostic category claim batches are received, our investigative staff track and trend elements across all claims and medical service providers.

Our approach is a proven process of investigating and profiling claims and provider practices. Here’s how it works:

Program-Integrity

Once an investigation is complete, a formal report is delivered on each batch of claims in an investigated diagnosis category. Reports include the findings on overpaid claims as well as recommendations based on trends received. Recommendations include coding enhancements, provider contract enhancements, provider outreach, on-site and desk audits, unannounced audits, provider self-audits, and training sessions.

Valiant Health’s program integrity services result in the following benefits:

      • Controlling Wasteful Spending
      • Ensuring Compliance With the Law
      • Reducing Future Claim Payments

Valiant Health clients are continuously challenged to find more ways to identify inaccuracies and eliminate overpayments in claims. However, they have limited resources. We provide those missing resources to leverage your existing teams and processes, improve operational performance through advanced technology and workflow management, and to apply clinical and coding expertise.

An ROI of 5:1 is common utilizing Valiant Health’s solutions. To test our results, ask us about our customized, no-risk solution program.