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Average Ratings 0 Ratings
Description
HealthRules® Payer represents a cutting-edge core administrative processing system that offers transformative features for health plans across various types and sizes. For over a decade, health plans utilizing HealthRules Payer have effectively capitalized on market opportunities, maintaining a competitive edge. What sets HealthRules Payer apart from other core administrative solutions is its innovative application of the patented HealthRules Language™, which resembles English and introduces a groundbreaking methodology for configuration, claims management, and information transparency. This system empowers health plans by enabling them to expand, innovate, and outperform their peers more effectively than any other core system available today. As a result, HealthRules Payer not only streamlines operations but also fosters a culture of agility and responsiveness within health organizations.
Description
Enhance clinical quality metrics, improve the accuracy of risk scores, boost patient and provider involvement, elevate patient outcomes, ensure operational transparency, and optimize economic performance through a singular, integrated suite of software solutions. The Inovalon Payer Cloud revolutionizes conventional workflows by transitioning them into data-driven methodologies that align with your health plan’s primary goals. Supported by top-tier analytics capabilities, our unified SaaS solutions provide the essential member-centric insights along with the speed, precision, and adaptability required to maintain a competitive edge in today’s varied and rapidly evolving market. Inovalon's healthcare payer SaaS suite not only delivers valuable insights and actionable strategies but also empowers health plans to assess, manage, and enhance health outcomes, economic efficiency, and the overall quality of care. With our payer solutions, stakeholders can achieve improved member care and outcomes while simultaneously enhancing operational performance and efficiency, leveraging advanced analytics and agile business intelligence tools to navigate the complexities of the healthcare landscape more effectively. As a result, organizations can cultivate a proactive approach to healthcare management, ensuring they are well-equipped to meet both current and future challenges.
API Access
Has API
API Access
Has API
Integrations
Inovalon ONE Platform
Pricing Details
No price information available.
Free Trial
Free Version
Pricing Details
No price information available.
Free Trial
Free Version
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Vendor Details
Company Name
HealthEdge Software
Website
www.healthedge.com
Vendor Details
Company Name
Inovalon
Country
United States
Website
www.inovalon.com/products/payer-cloud/
Product Features
Claims Processing
Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration
Product Features
Insurance Claims Management
CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting