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AI-powered Health Plan Solutions for Medicare, Medicaid plans AI-powered Health Plan Solutions for Medicare, Medicaid plans

AI-powered Health Plan Solutions to Sustain
Continuous Compliance

  • 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

    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.

Audit & Monitoring

Efficiently audit and monitor compliance readiness by centralizing and automating critical processes.

Risk Management

Risk Management

Confidently guide health plans to manage risks relevant to their businesses with real-time data.

Automate the entire compliance life cycle with AI-powered Health Plan solutions

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.

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.

Medicaid

Establish and operate effective compliance programs to determine if your departments and providers meet regulatory requirements.

Commercial

Provide better member service for improved member experience, enhance provider engagement, and maintain contracted service levels.

PBM

Improve compliance and quality management requirement oversight of pharmacy benefit managers and operations.

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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

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.

Collateral

If you need automated A&G, Regulatory Compliance or CMS Program Audit solutions, you can find your answers here.

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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