Initial product launch reveals significant
financial benefits for payers and providers
OAK
BROOK, Ill., May 22, 2024
/PRNewswire/ -- Avaneer Health, a decentralized digital
network and platform for simplifying the business of healthcare,
today announced that it has launched Avaneer Coverage Direct™ for
healthcare payers and providers. Avaneer Coverage Direct
proactively delivers accurate, real-time health insurance coverage
information on a secure, peer-to-peer network of payers and
providers, lowering operations and systems costs while enhancing
the patient/member experience.
Current and accurate coverage information is vital for
efficiently managing claims, avoiding denials, facilitating timely
provider reimbursement, and minimizing unnecessary administrative
complexities for consumers. Today, providers use multiple
electronic data interchange (EDI) transactions with limited
discovery capability, manual processes, and retrospective
analytics. Avaneer Health takes a new and different approach.
Payers and providers connect directly to Avaneer Health's
decentralized network where Avaneer Coverage
Direct provides enhanced discovery and updates of insurance
coverage information in near real-time. Further, the proactive
updates provide a holistic view of active, inactive, and upcoming
coverage, including new or secondary coverage when available.
"Avaneer Coverage Direct gives both the care provider and the
payer confidence that they each have the latest and most accurate
coverage information proactively available in their source
systems," says Stuart Hanson, CEO,
Avaneer Health. Hanson continues, "This level of insight creates
value for both payers and providers, while improving the patient
financial experience. This is the first solution of many in
development that are designed to uniquely reduce the cost and
complexity of healthcare."
Cleveland Clinic, the first Avaneer Coverage Direct provider
pilot participant, is innovating to ensure that it has the most
accurate coverage information upfront to eliminate delays in care
and inaccurate patient financial responsibility.
"We've been working with Avaneer Health since inception to
improve the patient and caregiver experience. Through a near
real-time data exchange, the expectation is to see fewer
discrepancies between what services are covered by the payer and
what providers offer to the patient, resulting in a decrease in
administrative overhead costs for both payers and providers. We are
excited to see the transformative impact on reducing the
administrative burden and enhancing the patient experience," says
Dennis Laraway, Chief Financial
Officer at Cleveland Clinic. "The initiative aligns with our goal
to provide the highest level of patient experience while also
improving overall financial performance and efficiency."
Hanson explains that Avaneer Coverage Direct can help improve
the patient/member experience and transform the process for payers
and providers to update and access the latest coverage information,
which will unlock unprecedented cost savings for both payers and
providers. "Avaneer Coverage Direct can deliver short-term, hard
value of between $3.35 to
$5.75 per claim for providers and up
to $1.65 per claim for payers," says
Hanson. "Most provider savings come from reducing manual
verification, preventing or reducing the need to rework denied
claims, claim write-offs, and avoidable retroactive prior
authorizations. Payer savings are from more streamlined
adjudication, earlier data on coordination of benefits, reduced
call center volumes, and lower recovery costs."
With a single connection to the Avaneer Network™, payers and
providers submit data to their secure cloud environment, where it
becomes discoverable solely by their designated trading partners on
the Avaneer Network, based on permissions set by each organization.
Data remains under the control of the data owner or originator.
When new data for a member/patient is added or current data
updated, Avaneer Coverage Direct determines missing, conflicting,
and incorrect details automatically, and enables participants to
directly exchange information.
About Avaneer Health
Avaneer Health is a
decentralized digital network and platform for
simplifying the business of healthcare. Designed as a modern IT
infrastructure for healthcare data sharing, Avaneer Health is
breaking down the barriers and data silos to improve healthcare
experiences, speed of care, and enabling applications that drive
significant administrative savings. The Avaneer platform is
cloud-based and FHIR native, enabling secure and permission-based,
peer-to-peer access to other organizations with shared
members/patients on the network. Avaneer Health was founded in 2020
by a consortium of industry leaders including Aetna, a CVS Health
company; Elevance Health; Cleveland Clinic; Health Care Service
Corporation, a Mutual Legal Reserve Company (HCSC); Sentara
Healthcare; The PNC Financial Services Group, Inc.; and Merative.
These founding members remain engaged with the company and its
mission to solve inefficiencies in the healthcare industry. For
more information, visit AvaneerHealth.com and follow Avaneer Health
on LinkedIn.
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SOURCE Avaneer Health