Inovalon Claims Management Pro

42 reviews

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

Inovalon Eligibility Verification

19 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 Direct Data Entry Verification

14 reviews

Connect in real time to FISS to enter claims, check status, and update RTPs without switching systems or slowing down.

Inovalon Claims Management Medicare Pro

12 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 Schedule Management

9 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 Claims Management Starter

5 reviews

Get claims out the door effortlessly – every single time – with a solution that helps you work smarter, not harder. Built for simplicity, Claims Management Starter helps you maximize efficiency and keeps you stress-free from day one, with one clear dashboard to work all your claims.