Industry-Leading Health Plan Platform

Health plan solutions with compliance designed into the core

Medicare

Medicare

Whether complying with Medicare, Medicare Advantage, Medicare Advantage Part C and Part D or Medicare-Medicaid (MMP), Inovaare has health plans covered.

Medicaid

Medicaid

Improve the quality, efficiency and consistency of Medicaid services with Inovaare’s cloud-based health plan data platform.

Commercial

Commercial

Differentiation within the market is challenging. Discover how real-time automation will achieve it.

Health Plan Solutions to Sustain Continuous Compliance

As an industry leader of health plan solutions that drive digital transformation in healthcare, Inovaare automates complex Medicare, Medicaid and Commercial appeals and grievances (A&G) and Compliance Program Effectiveness (CPE) workflows. Its configurable cloud-based modules compile real-time data across internal and external departments, creating one compliance management system. The HIPAA-compliant platform integrates the most current, best-practice regulatory processes to help health plans efficiently meet their unique business requirements, sustain audit readiness, reduce non-compliance risks and lower overall operating costs.

Why Inovaare

Health Plan Solutions that help the largest healthcare payers achieve continuous regulatory compliance and better member experience

Are you leaving money on the table by placing other compliance concerns above the Medicare Advantage member experience? Don’t make that mistake.

Inovaare’s industry-leading Appeals & Grievances and Regulatory Compliance health plans solutions automate time-consuming manual compliance processes to ensure:

  • Higher CMS reimbursements
  • Reduced compliance audit risks
  • Lower operating costs

With over 125 years of healthcare regulatory expertise, Inovaare’s compliance consultants oversee the implementation process to ensure its customizable, HIPAA-compliant SaaS modules support CMS compliance and program audit readiness at a moment’s notice.

Member Issue Management

Appeals and Grievances

Ensure timely responses and generate clean universes with the touch of a button.

Complaint Tracking Module

Identify, report, manage and resolve complaints efficiently.

Sales Allegations

Make certain complaints are investigated and closed properly, reducing non-compliance risk.

Health Plan Solutions for

Regulatory Compliance Solutions

Configurable software form a centralized compliance system that optimizes risk identification, supports operations and displays intuitive analytics dashboards. This facilitates better decision making to ensure health plans are continuously compliant. Each of these cloud-based modules help health plans improve compliance program effectiveness (CPE) but, together, they drive it.

Audit & Monitoring

Know compliance can be proven at any time without notice

Scan in Minutes

Automated CMS Universe Management
Explore solutions

Compliance

Achieve continuous compliance in real time

Comply 24/7/365

Automated Regulatory Compliance Processes
Explore solutions

Issue & CAP

Ensure Corrective Action Plans yield intended results

Monitor Results

Automated Corrective Action Plan Processes
Explore solutions

Regulatory Library

Rest easy knowing compliance rules are up-to-date in real time

Know the Score

Built-in CMS and State Regulatory Rules
Explore solutions

Important Announcements

New Appeals & Grievances Product

A&G Pro 30, the first cloud-based Appeals and Grievances software that can be fully implemented within 30 days.
New

Real-Time A&G and Compliance Central

The CMS recently released its 2020 Medicare, Medicaid, MMP and TMP Final Protocols. Here's what it means for health plans.
Blog

CMS 2021 Audit Protocol Changes

Health plans can efficiently respond to any regulatory notice and submit compliant reports with the touch of a button.
Blog