Valence Solutions

Running Your Health Plan

Creating and running a health plan means taking on all sorts of new responsibilities—claims payment, customer service and medical management. In addition to designing and implementing provider-sponsored health plans (PSHPs) for clients, Valence Health offers the full scope of managed services clients need to start and/or optimize their operations. Utilizing our staff of seasoned professionals, with an average of more than 10 years of industry experience, we perform core functions on behalf of our clients so they can focus on their patients. From medical management to claims processing to financial reporting, Valence Health creates a customized relationship with each client. These relationships often evolve over time as customers gain experience, scale and confidence. With the goal of a long-term partnership in operating sustainable high value PSHPs, we've been partnering with forward-minded providers since 1996.

Our Managed Services Include: 

  • Provider relations
  • Complete member management
  • Benefit coordination
  • Member and provider call center
  • Claims processing
  • Financial accounting and reporting (internal and regulatory)
  • Care management
  • Cost and utilization analysis and management
  • Provider capitation and reimbursement payments
  • Broker commission management

Client Benefits:

  • Bridge hospital clinical and administrative priorities
    for provider-sponsored health plans
  • Empower clients to start their own health plan quickly and cost effectively
  • Facilitate adoption of tested “best practice” methodologies
  • Provide “instant-on” bandwidth and expertise to take advantage of market opportunities
  • Empower clients to optimize and grow sustainable high-value PSHPs