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Description
Ensure a steady stream of revenue by utilizing a robust platform that accelerates reimbursements through eligibility verification, tracking claims status, conducting audits and appeals, and managing remittances for both government and commercial claims, all integrated into one cohesive system. Take advantage of a sophisticated rules engine that promptly cleanses claims in accordance with the latest CMS and commercial payer regulations, enabling you to rectify any inaccuracies prior to submission. During the claim upload process, confirm eligibility across all payers and identify any flagged issues, allowing for necessary edits before the claims are sent. Reduce the days in accounts receivable by implementing automated workflows for handling audit responses, submitting appeals, and tracking administrative dispute resolutions. Tailor staff workflow assignments based on the specific claim type and required actions. Additionally, automate the submission of secondary claims to prevent timely filing write-offs. Ultimately, enhance your claims revenue through automated workflows that facilitate quicker and more successful audits and appeals, ensuring your organization remains financially healthy. Furthermore, this comprehensive system can adapt to your evolving needs, providing long-term benefits as your operations grow.
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
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
Inovalon
Founded
1998
Country
United States
Website
www.inovalon.com/products/provider-cloud/revenue-cycle-management/all-payer-revenue-cycle-management/
Vendor Details
Company Name
Inovalon
Country
United States
Website
www.inovalon.com/products/payer-cloud/
Product Features
Insurance Claims Management
CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting
Product Features
Insurance Claims Management
CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting