Inovalon Claims Management Pro

20 reviews

Claims Management Pro is a comprehensive SaaS-based claims management solution that far outpaces the average clearinghouse.

Inovalon Eligibility Verification

12 reviews

Eligibility Verification facilitates real-time eligibility and benefits determination for commercial and federal payers. With this proven SaaS solution, you get fast, automated access to detailed eligibility and medical benefit information from hundreds of commercial, Medicare, and Medicaid payers, including Medicare supplements, Medicare Advantage, and state Medicaid plans.

ABILITY EASE All-Payer

6 reviews

ABILITY EASE All-Payer was engineered by leveraging over a decade of experience troubleshooting EDI submission pain points to create a system that reduces first-pass rejections.

Inovalon Schedule Management

5 reviews

Inovalon Schedule Management is a cloud-based software solution designed to optimize staff scheduling and human capital management within healthcare organizations. By automating and streamlining scheduling processes, it helps reduce labor costs, prevent overtime, decrease employee turnover, and enhance overall scheduling efficiency. This allows healthcare providers to focus more on delivering quality patient care. Key Features and Functionality: - Online Staff Scheduling: Facilitates point-and-click scheduling, template-based shifts, and last-minute availability adjustments. - PowerScheduler: Offers dynamic schedule views in various formats, providing managers with critical decision-making information down to the employee level. - SupervisorView: Enables supervisors to oversee patient flow and allocate resources effectively by displaying staffing and census data across care areas on a single screen. - Open Shift Management: Engages staff collaboratively to fill open shifts, allowing qualified employees to request shifts and managers to approve or decline based on factors like overtime and seniority. - xPPD/HPPD Staffing: Automates staffing calculations based on defined ratios, ensuring appropriate staffing levels in relation to patient census. - AutoScheduler: Utilizes rules-based algorithms to fill schedule gaps quickly and fairly, considering employee availability and seniority. - TeamScheduler: Simplifies the scheduling of teams or pods, streamlining management and adjustments for groups that work together regularly. - Credentialer®: Tracks staff credentials, certifications, and licenses, providing alerts for expirations and the ability to upload related documents. - Integration Engine: Ensures seamless data synchronization between HR, scheduling, and time & attendance systems, reducing redundant data entry and updates. Primary Value and Solutions Provided: Inovalon Schedule Management addresses critical challenges in healthcare staffing by automating and optimizing scheduling processes. It reduces administrative burdens, minimizes labor costs, and enhances staff satisfaction by providing predictable schedules and reducing last-minute changes. The platform's comprehensive tools ensure consistent shift coverage, improve communication, and maintain compliance with staffing ratios. By integrating with third-party agency management, it also streamlines the use of temporary staff, reducing associated costs by up to 25%. Overall, the solution empowers healthcare organizations to deliver superior patient care through efficient and effective workforce management.

Inovalon Patient Payment Management

3 reviews

Patient Payment Management (formerly ABILITY SECUREPAY) is a comprehensive patient payment software that enables you to capture more revenue and improve patient satisfaction. By accepting all forms of payment and offering flexible payment options, you can help patients quickly understand what they owe and better facilitate payments.

Inovalon ONE Platform

2 reviews

The Inovalon ONE Platform is an integrated, cloud-based platform of more than 80 individual proprietary toolsets that can be rapidly configured to empower the operationalization of very large-scale data-driven healthcare initiatives that are highly differentiated, efficient, modular and flexible.

ABILITY PC-ACE

2 reviews

ABILITY | PC-ACE is a complete electronic claims submission and management software application. It can be used in a standalone configuration or in conjunction with your existing claims management system.

ABILITY CAREWATCH

1 review

Its so much more than a scrubbing tool for MDS assessments! With ABILITY CAREWATCH youll have the right tools to simplify quality management and strengthen your business across the enterprise.

Inovalon Insurance Discovery

1 review

Inovalon Insurance Discovery is a robust Software-as-a-Service (SaaS solution designed to assist healthcare providers in maximizing reimbursements and minimizing uncompensated care. By leveraging advanced algorithms, it identifies primary, secondary, and tertiary insurance coverage, ensuring that every applicable payer is recognized for a claim. This process significantly reduces claims denials and accelerates the revenue cycle, leading to improved financial outcomes for healthcare organizations. Key Features and Functionality: - Automated Insurance Discovery: Utilizes sophisticated algorithms to search patient information against public and private payers, identifying all applicable insurance coverage. - Confidence Scoring: Provides confidence scores for identified coverage, differentiating between managed care and advantage plans to ensure accuracy. - High Identification Rate: Achieves an average insurance identification match rate of 39.5% on uninsured accounts, enabling more claims to be processed directly by payers rather than being categorized as self-pay, charity, or bad debt. - Seamless Integration: Integrates with existing registration and Electronic Health Record (EHR systems, complementing current workflows without disruption. - Real-Time Eligibility Checks: Conducts real-time eligibility verifications, contributing to a clean claims rate exceeding 99%. Primary Value and Problem Solved: Inovalon Insurance Discovery addresses the critical challenge of uncompensated care and revenue loss due to unidentified or incorrect insurance information. By automating the insurance discovery process, it ensures that healthcare providers can accurately identify all available coverage options for patients. This leads to a reduction in claims denials, faster reimbursements, and a more efficient revenue cycle. Additionally, by decreasing the reliance on manual processes, it allows front-end staff to focus more on patient care and less on administrative tasks, ultimately enhancing the overall patient experience.