Inovalon Claims Management Pro

28 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.

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.

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.

Inovalon Claims Management Medicare Pro

0 reviews

Inovalon's Claims Management Medicare Pro is a specialized cloud-based solution designed to enhance Medicare revenue cycle management for healthcare providers. By integrating seamlessly with existing systems, it offers real-time insights and automation to streamline billing processes, reduce errors, and accelerate reimbursements. This solution empowers providers to proactively monitor and verify Medicare status, manage billing efficiently, and automate tasks such as RAC audits and Additional Development Requests , ultimately improving financial performance and patient satisfaction. Key Features and Functionality: - Automated Eligibility Checks: Conduct unlimited, real-time eligibility verifications at no extra cost, ensuring accurate billing and reducing claim denials. - Proactive Monitoring: Receive weekly alerts on changes in Medicare eligibility, including Medicare Advantage, to stay informed and responsive. - Claims Management: Access intuitive dashboards displaying timely claims information, facilitating efficient tracking and resolution. - Automated Workflows: Streamline claims resolution with automated processes, reducing manual tasks and expediting reimbursements. - Seamless Integration: Utilize single sign-on capabilities to integrate with platforms like PointClickCare, enhancing user experience and data accessibility. Primary Value and Solutions Provided: Claims Management Medicare Pro addresses the complexities of Medicare billing by offering a comprehensive, automated solution that reduces administrative burdens and financial risks. By ensuring a 99% or better clean claims rate across commercial, Medicare, and Medicaid payers, it minimizes errors and accelerates cash flow. The system's proactive monitoring and real-time insights enable providers to make informed decisions, optimize revenue cycles, and focus more on patient care.

Inovalon RCM Intelligence

0 reviews

Inovalon RCM Intelligence is a cloud-based software solution designed to enhance healthcare providers' revenue cycle management by offering comprehensive data visualization and analytics. By integrating real-time insights into key performance indicators such as payer performance, denial rates, and claims corrections, RCM Intelligence empowers providers to optimize financial operations and focus more on patient care. Key Features and Functionality: - Real-Time Revenue Insights: Provides interactive dashboards that display payment trends, cash flow projections, and payer performance metrics, enabling informed financial decision-making. - Denial Management: Identifies root causes of claim denials and suggests corrective actions to improve first-pass yield rates, reducing the need for rework and accelerating reimbursements. - Automated Reporting: Delivers pre-configured reports that predict potential denials, allowing proactive measures to prevent revenue loss. - Clearinghouse Compatibility: Supports integration with all electronic data interchange claims clearinghouses, ensuring seamless connectivity with various payers, including commercial, Medicare, and Medicaid. Primary Value and Problem Solved: RCM Intelligence addresses the challenges healthcare providers face with revenue leakage and inefficient claims processing. By offering actionable insights and automating key aspects of the revenue cycle, the solution helps reduce claim denials, improve cash flow by up to 15%, and achieve first-pass yield rates of up to 93%. This leads to enhanced financial performance, allowing providers to allocate more resources toward delivering quality patient care.

Inovalon Patient Statement Management

0 reviews

Featuring an easy-to-read breakdown of outstanding balances, ABILITY Patient Statements increase your patients ability to understand your bills, decreasing both patient phone calls and payment delays for your practice.