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AI-powered Health Plan Solutions for Medicare, Medicaid plans AI-powered Health
Plan Solutions for Medicare, Medicaid plans
INOVAARE
--------------------------------------------------------------------------------
AI-POWERED HEALTHCARE PAYER SOLUTIONS
EMPOWERING HEALTH PLANS WITH POWERFUL OPERATION AND COMPLIANCE SOLUTIONS
Book Free Consultation!
AI-POWERED OPERATION AND COMPLIANCE SOLUTIONS FOR HEALTHCARE PAYERS
* Appeals & Grievances
* Audit Readiness
* Risk & Compliance
* Data Warehouse
* Reporting & Analytics
* APPEALS & GRIEVANCES
Appeals and grievances system with built-in compliance, workforce management
and one-click universes
* AUDIT READINESS
CMS universe management system for one-click universe generation and
on-demand scrubbing of all universe tables for issue identification within
minutes
* RISK & COMPLIANCE
The CMS compliance module aligns with the latest CMS updates (i.e., HPMS) and
helps plans create accurate risk assessments, manage corrective action plans
(CAPs) and assign delegated tasks.
* DATA WAREHOUSE
Centralized data repository for on-demand analytics and reporting through
user-friendly, scalable interfaces that require minimal administration.
* REPORTING & ANALYTICS
Business intelligence system with advanced reporting and analytics as well as
ad hoc report and dashboard generation
* CRM Member/ Provider
* Appeals & Grievances
* Audit Readiness
* Risk & Compliance
* Data Warehouse
* Reporting & Analytics
* CRM MEMBER/PROVIDER
Customer Relationship Management system exclusively focused on the
operational and regulatory needs of health plan
* APPEALS & GRIEVANCES
Appeals and grievances system with built-in compliance, workforce management
and one-click universes
* AUDIT READINESS
CMS universe management system for one-click universe generation and
on-demand scrubbing of all universe tables for issue identification within
minutes
* RISK & COMPLIANCE
The CMS compliance module aligns with the latest CMS updates (i.e., HPMS) and
helps plans create accurate risk assessments, manage corrective action plans
(CAPs) and assign delegated tasks.
* DATA WAREHOUSE
Centralized data repository for on-demand analytics and reporting through
user-friendly, scalable interfaces that require minimal administration.
* REPORTING & ANALYTICS
Business intelligence system with advanced reporting and analytics as well as
ad hoc report and dashboard generation
Improve Member Experiences
Ensure Faster Issue Resolution
Achieve Continuous Audit Readiness
Mitigate Risk for Better Operational Health
Make Better Decisions with Real-time Reports
APPEALS AND GRIEVANCES
Resolve the disconnect between multiple legacy systems to effectively engage
members at every touchpoint in real time.
* Adhere to appeals and grievances compliance deadlines and requirements
* Monitor changes at each state of the complaint process
* Track and trend sales allegations outcomes
Explore solutions
Click for sound
2:25
Click for sound
3:17
AUDIT & MONITORING
Efficiently audit and monitor compliance readiness by centralizing and
automating critical processes.
* View audits and monitor process data in real time
* Track findings, recommendations and action plans
* Generate on-demand reports and analytics
Explore solutions
RISK MANAGEMENT
Confidently guide health plans to manage risks relevant to their businesses with
real-time data.
* Manage contract life cycles
* Implement contract analytics
* Track all contract parameters
Explore solutions
AUTOMATE HEALTH PLAN OPERATIONS AND COMPLIANCE MANAGEMENT LIFE CYCLE
Inovaare partners with health plans to deliver AI-driven automation solutions
that populate compliance, operations and analytics tools with real-time data to
guide oversight and generate compliant regulatory reports at the touch of a
button.
* Drive compliance with the latest regulatory protocols embedded
* Conduct regular mock audits and monitor process data in real time
* Improve A&G turnaround times for better member experiences
Request a demo
CLIENT TESTIMONIALS
"We appreciate Inovaare team for working with us and helping to identify ways to
improve our process in the Inovaare platform. We will continue to work with the
team on other opportunities."
Kristi Cooper RN, BSN
Managing Director, Clinical Operations‐Medicare Plans
Advantasure
"I feel we made the right choice with Inovaare as they have been an incredible
partner. The scrubbers and platform were tested during CMS TMP reviews and our
CMS Comprehensive Program Audit last year. Our CPE audit results were excellent,
and we had no findings. Authentic team and platform that works!"
Mayra R. Campuzano, CHC
Vice President, Compliance Officer
Doctors Healthcare Plans Inc
"Thank you to all involved. It's a great first step in improving our
efficiencies. This is a partnership, and we appreciate the support."
Connie Minerich
Senior Vice President, Operations
Advantasure
"I just want to take a minute more of your time to let you know how grateful I
am for your partnership and support. I recognize how much effort you put into
responding promptly (even when it is isn’t necessary!), making sure I am
informed of changes, walking me through how to do things when needed, etc. You
are very knowledgeable and always willing to help, which I very much appreciate.
You are also kind, patient, and friendly, so a pleasure to work with. Simply
stated, thank you! Thank you for everything you do."
A Senior Compliance Professional from a Leading U.S. Health Plan
"Thank you for all your hard work, dedication, and selflessness that you give to
our CHG Team. Your commitment to helping our team never seizes to amaze me. You
are always working above and beyond normal expectations to support and improve
our services. The enthusiasm you bring to the table brings a smile to face and
it is such a joy to work with you. With your help we have been able to develop
and implement ideas that will enhance and improve our processes and
productivity."
Daphne Cheney, Corporate Quality Project Coordinator, Community Health Group
(CHG)
"We appreciate Inovaare team for working with us and helping to identify ways to
improve our process in the Inovaare platform. We will continue to work with the
team on other opportunities."
Kristi Cooper RN, BSN
Managing Director, Clinical Operations‐Medicare Plans
Advantasure
"I feel we made the right choice with Inovaare as they have been an incredible
partner. The scrubbers and platform were tested during CMS TMP reviews and our
CMS Comprehensive Program Audit last year. Our CPE audit results were excellent,
and we had no findings. Authentic team and platform that works!"
Mayra R. Campuzano, CHC
Vice President, Compliance Officer
Doctors Healthcare Plans Inc
"Thank you to all involved. It's a great first step in improving our
efficiencies. This is a partnership, and we appreciate the support."
Connie Minerich
Senior Vice President, Operations
Advantasure
"I just want to take a minute more of your time to let you know how grateful I
am for your partnership and support. I recognize how much effort you put into
responding promptly (even when it is isn’t necessary!), making sure I am
informed of changes, walking me through how to do things when needed, etc. You
are very knowledgeable and always willing to help, which I very much appreciate.
You are also kind, patient, and friendly, so a pleasure to work with. Simply
stated, thank you! Thank you for everything you do."
A Senior Compliance Professional from a Leading U.S. Health Plan
"Thank you for all your hard work, dedication, and selflessness that you give to
our CHG Team. Your commitment to helping our team never seizes to amaze me. You
are always working above and beyond normal expectations to support and improve
our services. The enthusiasm you bring to the table brings a smile to face and
it is such a joy to work with you. With your help we have been able to develop
and implement ideas that will enhance and improve our processes and
productivity."
Daphne Cheney, Corporate Quality Project Coordinator, Community Health Group
(CHG)
"We appreciate Inovaare team for working with us and helping to identify ways to
improve our process in the Inovaare platform. We will continue to work with the
team on other opportunities."
Kristi Cooper RN, BSN
Managing Director, Clinical Operations‐Medicare Plans
Advantasure
"I feel we made the right choice with Inovaare as they have been an incredible
partner. The scrubbers and platform were tested during CMS TMP reviews and our
CMS Comprehensive Program Audit last year. Our CPE audit results were excellent,
and we had no findings. Authentic team and platform that works!"
Mayra R. Campuzano, CHC
Vice President, Compliance Officer
Doctors Healthcare Plans Inc
"Thank you to all involved. It's a great first step in improving our
efficiencies. This is a partnership, and we appreciate the support."
Connie Minerich
Senior Vice President, Operations
Advantasure
"I just want to take a minute more of your time to let you know how grateful I
am for your partnership and support. I recognize how much effort you put into
responding promptly (even when it is isn’t necessary!), making sure I am
informed of changes, walking me through how to do things when needed, etc. You
are very knowledgeable and always willing to help, which I very much appreciate.
You are also kind, patient, and friendly, so a pleasure to work with. Simply
stated, thank you! Thank you for everything you do."
A Senior Compliance Professional from a Leading U.S. Health Plan
"Thank you for all your hard work, dedication, and selflessness that you give to
our CHG Team. Your commitment to helping our team never seizes to amaze me. You
are always working above and beyond normal expectations to support and improve
our services. The enthusiasm you bring to the table brings a smile to face and
it is such a joy to work with you. With your help we have been able to develop
and implement ideas that will enhance and improve our processes and
productivity."
Daphne Cheney, Corporate Quality Project Coordinator, Community Health Group
(CHG)
Previous slide
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MARKETS SERVED
EMPOWERING HEALTH PLANS TO SUSTAIN FEDERAL, STATE AND COMMERCIAL COMPLIANCE.
MEDICARE
Centralize MA/MAPD program requirements, automate CMS compliance processes and
monitor compliance initiatives in real time.
Learn more
MEDICAID
Establish and operate effective compliance programs to determine if your
departments and providers meet regulatory requirements.
Learn more
COMMERCIAL
Provide better member service for improved member experience, enhance provider
engagement, and maintain contracted service levels.
Learn more
PBM
Improve compliance and quality management requirement oversight of pharmacy
benefit managers and operations.
Learn more
Watch now
Obtain a quick understanding of how Inovaare drives digital transformation
within the healthcare industry through our growing video library. While some of
our videos are dramatic and others are entertaining, they’re always informative.
VIDEOS
BLOGS
A perspective on recent industry shifts influencing ACA plan operations in
states, which are yet to adopt ACA Medicaid expansion
Access blogs
Join us here
WEBINARS
Experience why Inovaare remains a trusted authority within the healthcare
industry. All presenters are industry thought leaders who make your interests a
priority.
CASE STUDIES
Don’t just take our word for it. Learn how existing Inovaare clients benefit
from Inovaare’s digital transformation, backed up by real-world results.
Explore benefits
Download flyers
COLLATERAL
If you need automated A&G, Regulatory Compliance or CMS Program Audit solutions,
you can find your answers here.
Request eBook
Visit our eBook library and experience why Inovaare is a trusted industry
thought leader. Check back regularly as we will continue to provide unparalleled
insight into Appeals & Grievances and Risk & Compliance best practices.
E-BOOKS
--------------------------------------------------------------------------------
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