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Automation Enhances Administrative Efficiency

To be at the top of the Medicaid segment, payer plans must reduce operational inefficiencies, especially since Medicaid program administration is plagued by rampant insurance fraud and abuse. Detecting and deterring these criminal elements form the core of quality compliance audit tools.

Inovaare’s suite of comprehensive solutions for Medicaid providers addresses:

  • Claims processing
  • Medical management
  • Administrative activities
  • Network management
Inovaare supports Medicaid providers, including hospitals, to navigate the complex maze of Medicaid audit processes. Inovaare’s audit solution for Medicaid compliance helps payer plans to investigate suspicious provider activity, allowing them to quickly recover illegitimate claims, if processed, and track provider compliance with Medicaid program statutes.

Key Benefits

  • Consistent CMS regulatory compliance
  • Increased administrative and operational efficiency
  • Intelligent automation to administer diverse plan designs
  • Lower operational cost
  • Easy third-party solution integration
  • Rapid adaptation to quickly evolving CMS regulations

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