Inovalon Insurance Discovery

5/5(2)

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 Eligibility Verification

4.4/5(14)

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.