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 as-needed answers-on-demand to large-scale project-based solutions.

  • Chargemaster reviews to mitigate line-item denials

  • Implementation and coding/billing support for technology-based clinical services, including remote monitoring and telehealth

  • Provider-based department attestations, NPI applications financial analysis and operational/revenue cycle conversions (i.e., provider-based to freestanding)

  • Inpatient-only procedure phase-out mitigation strategies

  • Pre-service coverage implementation support for WISeR and CMS LCD/NCD and other payer coverage

  • Fast ROI: elimination of unnecessary series/monthly billing and 3-day window bundling

  • Denial mitigation strategies and workflow design

  • New product/service onboarding of novel therapies and devices

  • Clinical trial billing compliance

  • In-person and web-enabled educational services regarding all aspects of revenue integrity

  • Advocacy with Medicare Administrative Contractors (MACs) and the Centers for Medicare and Medicaid Services (CMS) on coverage, coding, billing 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

Our Experts

Contact Us

Interested in working with us? Having a burning reimbursement question? Fill out some info and we will be in touch shortly. We can’t wait to hear from you!