About
Valorize Consulting
Founded in 2015, Valorize Consulting LLC is a healthcare reimbursement and advisory firm designed to leverage expertise and experience in a cost-efficient manner possible.
Our clients include hospitals, physician practices, payers, manufacturers, hospital and professional associations, and legal firms. Valorize has deep expertise addressing challenging coding, billing, reimbursement and chargemaster issues. This is the foundation of all our work, including supporting for market access initiatives and reimbursement policy education for novel therapeutics, devices, and diagnostics. Learn more about our services below.
Our Services
Providers & Speciality Societies
Our solutions range from retainer agreements, where specific questions are raised as they occur, to large-scale project-based solutions.
Chargemaster reviews
Provider-based department financial analysis and operational/revenue cycle conversions (i.e., provider-based to freestanding)
Denial analysis and management program design
New product/service coverage and payment analysis
Payment model design for new services
In-person and web-enabled educational services
Advocacy with the Centers for Medicare and Medicaid Services (CMS) on coverage, coding, and payment
Manufacturers & Biotech Innovators
Our projects are designed to support the commercialization of novel diagnostics and therapeutics, including biologics, drugs and devices.
Launch blueprint development detailing key coding and reimbursement workstreams
Coding analyses for inpatient, outpatient, and professional billing of diagnosis, procedure, product and other codes (ICD-10, CPT, HCPCS)
New diagnosis, ICD-10-PCS procedure code, and CPT and HCPCS product (J-code) and procedure code requests
New Tech APC applications to CMS
Content creation and validation of coding and billing guide and customer-facing materials
Market access team training
Law Firms & Litigation Support
Our expertise in revenue cycle operations and HIPAA transaction set requirements for coding and billing helps us support litigation as consultants.
We provide expert testimony in written and oral formats
Primarily testifies for healthcare providers, both hospitals and professionals
Experienced supporting litigation on DRG downgrades, Emergency Department (ED) downgrades, line-item charge denials, and provider-based disputes
Testified in over 20 cases in 4 years
Our Experts
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Valerie founded Valorize in 2015, bringing more than 40 years of healthcare consulting experience.
Valerie began at the Health Care Financing Administration (HCFA), now the Centers for Medicare and Medicaid Services (CMS). On a federal level, she held positions at the U.S. Department of Health and Human Services (HHS), including with the Assistant Secretary for Management and Budget (ASMB), Assistant Secretary for Planning and Evaluation (ASPE), as well as HCFA.
She has served as a reimbursement manager for a large academic medical center, overseeing cost reporting, reopening and appeals, and lead projects implementing Medicare requirements in conjunction with the school of medicine.
Valerie has also served as a healthcare system revenue cycle director for 10 years, and as a consultant for Navigant, and Health Revenue Assurance Associations.
Publications list upon request.
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Amy has been with Valorize Consulting since the firm’s founding in 2015. Amy focuses on Medicare payment policy for novel therapies, such as cell and gene therapies.
She has a strong focus on coding analysis and strategic support for commercialization, including assisting industry clients with blueprint production for coding and reimbursement requirements necessary for product launch, the preparation and review of coding and billing guides and other customer-facing materials, and market access team training and education.
Amy also focuses on quality reporting requirements and implementation for providers, CMS Innovation and alternative payment model comparison, and supports expert witness documentation analyses.
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TBD on listing contractors here
Contact Us
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