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About

For providers, medical necessity denials cost thousands to millions of dollars every year in write-offs, plus costly staff time researching and appealing denials and responding to patient concerns. For payers, the same is true on the other end of the claim management spectrum: Paying for medically unnecessary procedures and treatments – and time spent working on denial appeals – raises costs without improving outcomes. And of course, for the patient, there can be unnecessary copays and other out-of-pocket costs, not to mention a poor patient experience involving costs and moments of care they did not need. ABN Assistant™ from Vālenz® Assurance delivers the prior authorization tools providers need to validate medical necessity, print Medicare-compliant ABNs with estimated cost, and stop over 90 percent of medical necessity denials by verifying necessity before care is delivered to the patient.

About

CareCost Estimate helps infusion centers and specialty medical practices answer the question every patient asks: what will this cost me? Staff pick the drug, dose, and insurance. CareCost returns the patient's out-of-pocket cost in about 90 seconds — including Medicare Part B coinsurance, secondary insurance and Medigap, weight-based dosing, and vial waste (JW/JZ). It then applies the manufacturer copay programs and foundation grants the patient may qualify for, so the number the patient hears is the real one. The same lookup shows what the payer requires first: prior authorization, step therapy, and site-of-care rules, quoted from the payer's own policy with a link. Drug prices come from CMS Average Sales Price files, updated every quarter. Estimates run in the browser, so patient data never reaches our servers. CareCost also publishes free billing and coding references for infusion CPT codes, J-codes, and modifiers, and the quarterly Infusion Reimbursement Index.

Platforms Supported

Windows Not Supported
Mac Not Supported
Linux Not Supported
Cloud Supported
On-Premises Not Supported
iPhone Not Supported
iPad Not Supported
Android Not Supported
Chromebook Not Supported

Platforms Supported

Windows Not Supported
Mac Not Supported
Linux Not Supported
Cloud Supported
On-Premises Not Supported
iPhone Not Supported
iPad Not Supported
Android Not Supported
Chromebook Not Supported

Audience

Medical providers searching for a solution to manage patients and payments

Audience

Infusion centers, specialty medical practices, and patient access and billing teams

Support

Phone Support Supported
24/7 Live Support Not Supported
Online Supported

Support

Phone Support Not Supported
24/7 Live Support Not Supported
Online Supported

API

Offers API Not Supported

API

Offers API Not Supported

Screenshots and Videos

Screenshots and Videos

No images available

Pricing

$1039.00/one-time/user
Free Version Not Supported
Free Trial Not Supported

Pricing

$189/month (first seat), $89/m
Free Version Not Supported
Free Trial Supported

Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

This software hasn't been reviewed yet. Be the first to provide a review:

Review this Software

Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

This software hasn't been reviewed yet. Be the first to provide a review:

Review this Software

Training

Documentation Supported
Webinars Not Supported
Live Online Supported
In Person Supported

Training

Documentation Supported
Webinars Not Supported
Live Online Not Supported
In Person Not Supported

Company Information

Vālenz
Founded: 2004
United States
www.valenzhealth.com/valenz-assurance/abn-assistant/

Company Information

CareCost
Founded: 2026
United States
carecostestimate.com

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Categories

Categories

Medical Billing Supported

Medical Billing Features

Claims Processing Not Supported
Claims Scrubbing Not Supported
Code & Charge Entry Not Supported
Compliance Tracking Supported
Customizable Dashboard Supported
Dunning Management Supported
Invoice History Supported
Patient Eligibility Checks Not Supported
Practice Management Not Supported
Quotes/Estimates Supported
Remittance Advice Supported

Integrations

No info available.

Integrations

No info available.
Claim ABN Assistant and update features and information
Claim ABN Assistant and update features and information
Claim CareCost Estimate and update features and information
Claim CareCost Estimate and update features and information