Next-Generation Healthcare Compliance Platform
Continuous Monitoring | AI-powered Health Plan Solutions | Regulatory Reporting | Business Intelligence
Appeals & Grievances
Provider Dispute Resolution
QIO Appeals
Member Services
Training Services
Issue Management
Corrective Action Plan
Regulatory Library
Contract & Policy Tracking
Policies & Procedures
Risk Management
Internal Audit
Internal Monitoring
External Audit
Delegation Oversight
Universe Scrubber
Universe Generator
FDR Universe Manager
Mock Audit
CMS Program Audit Services
Analytics
Analytics
Analytics
Analytics
AI-powered Health Plan Solutions to Sustain
Continuous Compliance
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CRM Member/ Provider
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Appeals & Grievances
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Audit Readiness
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Risk & Compliance
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Data Warehouse
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Reporting & Analytics
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CRM Member/Provider
Customer Relationship Management system exclusively focused on the operational and regulatory needs of health plan
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Appeals & Grievances
Appeals and grievances system with built-in compliance, workforce management and one-click universes
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Audit Readiness
CMS universe management system for one-click universe generation and on-demand scrubbing of all universe tables for issue identification within minutes
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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.
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Data Warehouse
Centralized data repository for on-demand analytics and reporting through user-friendly, scalable interfaces that require minimal administration.
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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
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
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
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.
- 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
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.
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.
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.