Transform Compliance & Operations with AI-Powered Healthcare Payer Solutions
Your health cloud platform to automate compliance oversight, streamline operations management, improve member experience and lower costs with advanced healthcare payer solutions.
Healthcare Native. Payer Approved.
Built on trust in health plan operations
impacted
served
What we solve for
What’s slowing down healthcare payers?
Ever-changing compliance regulations, data silos, and manual workflows create inefficiencies for your health plan. Our AI-powered A&G, Risk Management, and Regulatory Compliance solutions help health plans resolve these challenges with smart healthcare payer software for compliance automation.
Regulatory compliance risk
Regulatory compliance risk Staying compliant with regulations is time-consuming and error-prone and non-compliance could lead to penalties and audit failures.
Siloed, inaccessible data
Siloed, inaccessible data Legacy systems don’t communicate, making it hard to get a unified, real-time view of compliance and operational metrics.
Manual processes & inefficiencies
Manual processes & inefficiencies High-touch processes like appeals, grievances, and risk management slow teams down, increasing costs and delaying issue resolution.
Member experience challenges
Member experience challenges Slow responses and disconnected systems frustrate members, impacting member satisfaction, Star Ratings and retention.
Decoding compliance & operations
How we transform compliance &
operations for health plans
Our health cloud platform combines AI automation, real-time compliance tracking, and seamless workflows to cut costs,
reduce risk, and improve payer performance.
Compliance automation
Automates compliance with built-in rules, real-time tracking, and audit-ready workflows, improving efficiencies and reducing risk.
Unified API-first platform
Eliminates data silos by connecting disparate systems and delivering unified compliance insights and analytics.
Compliance-first approach
Ensures every workflow, update, and integration continuously align with the ever-changing regulatory requirements.
Member-first focus
Helps health plans deliver faster resolutions and creates better experiences, all while supporting compliance and reducing cost.
Explore our products Built for Healthcare Payers
Purpose-built platform for payer transformation
Transform compliance and operations with targeted cloud -based healthcare payer solutions built on a secure, scalable, and BOAT-powered Health Cloud platform for payers.
integrated artificial intelligence
The future of healthcare operations is agentic
We’re redefining healthcare payer solutions with task-specific AI Agents built on Usher AI. These AI Agents automate repetitive, error-prone tasks, improving compliance, reducing cost, and accelerating workflows. The result? Faster workflows. Smarter decisions. Lower cost.
Regulatory agent
Monitors, categorizes, and summarizes regulatory updates in real time to keep your team audit-ready.
Case intake agent
Captures, validates, and routes Appeals & Grievances cases to reduce errors and speed up resolution.
Audit notice agent
Reads notices, flags deadlines, and assigns tasks automatically to support timely responses, every time.
Data collection agent
Automates surveys and data gathering for payer data insights, fast analysis, and better decision making.
A platform you can trust
Secure. Compliant. Effortless.
HITRUST-certified
We protect your data with enterprise-grade security, encryption, and 24/7 monitoring.
HIPAA compliant
Built-in compliance features ensure smooth alignment with CMS, Medicare, and Medicaid.
Scalable architecture
Cloud-native, API-first, and auto-scaling for seamless growth and adaptability.
Transformational Recognition in Healthcare Technology
Inovaare Recognized in Gartner® Hype Cycle™ for Healthcare Payers
We’ve been recognized as a Sample Vendor in Gartner® “Hype Cycle for U.S. Healthcare Payers, 2024” report, for innovative solutions in the categories of LLMs for Healthcare Payers and Consumer-Centric Health Products.
Gartner® in it’s report “AI Reshapes How U.S. Healthcare Payer CIOs Do Business,” predicts that by 2027, GenAI solutions will reduce administrative cost by 30% for most health insurers with over a million members.
Disclaimers:
Gartner, Predicts 2025: AI Reshapes How U.S. Healthcare Payer CIOs Do Business, 16 January 2025, Faith Adams, Austynn Evansbank, Connie Salgy
Gartner, Hype Cycle for U.S. Healthcare Payers, 2024, 28 July 2024, Mandi Bishop, Austynn Evansbank, Connie Salgy GARTNER is a registered trademark and service mark, and Hype Cycle is a registered trademark of Gartner, Inc. and/or its affiliates in the U.S. and internationally and are used herein with permission. All rights reserved.
Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.
Hear from our customers
Our Value
Delivering measurable outcomes
We transform your healthcare operations, helping you save hours on audit-related documentation and reporting. Achieve significant compliance-related cost savings and ensure timely, accurate regulatory submissions.
Resources
FAQs
Have questions? We have answers.
Regulatory Compliance
Inovaare’s platform automates compliance tracking, ensures real-time regulatory updates, and provides audit-ready universes to keep health plans aligned with CMS, Medicare, and Medicaid regulations. With built-in rule-based automation, you can reduce compliance risks and improve audit outcomes effortlessly.
Our AI-powered platform adapts in real time to regulatory updates. Inovaare integrates compliance rule updates automatically, ensuring that your organization remains compliant without IT intervention. Stay ahead of policy shifts with proactive monitoring and automated workflows.
Pricing & Implementation
Implementation time varies based on the complexity of your operations, but most health plans can go live with Inovaare’s core solutions in under 90 days. Our modular, cloud-native architecture ensures a phased rollout that aligns with your business needs.
We offer 24/7 customer support, dedicated compliance consultants, and personalized training sessions to ensure seamless adoption. Our support team helps with onboarding, system optimization, and ongoing compliance updates to maximize your ROI.
Operations
By eliminating manual processes, reducing IT dependencies, and automating Appeals & Grievances (A&G), audits, and compliance tracking, Inovaare improves workflow efficiency across payer operations. AI-driven insights enhance decision-making, while self-service configuration allows for quick adaptability.
Yes. Inovaare’s automated scrubbing, pre-configured compliance checks, and real-time monitoring reduce audit preparation time by up to 90%. Health plans that implement Inovaare see a significant reduction in review time and external audit costs, leading to faster issue resolution and improved compliance performance.
Technology
Inovaare is API-first and built for interoperability, allowing seamless integration with EHRs, claims management systems, CRMs, and regulatory reporting tools. Our platform eliminates data silos, ensuring unified, real-time access to compliance and operational insights.
Our scalable cloud infrastructure supports multi-region deployments and auto-scaling, ensuring fast processing of high transaction volumes without performance degradation. Optimized data pipelines allow for real-time analytics and reporting, even with massive datasets.