Health Cloud Platform
The Health Cloud Platform for Health Plans
Inovaare’s HITRUST-certified, HIPAA-compliant health cloud platform eliminates the infrastructure complexity that slows health plans down. Purpose-built for Medicare Advantage, Medicaid and Commercial payers, it unifies compliance, operations, AI agents and data analytics on a single, secure foundation.
Grievances
Compliance
Management
Management
Oversight
Reporting
Platform Architecture
Deploy Today. Build What You Need Tomorrow.
Most health plans start with a pre-built module to solve an immediate problem. Over time, they expand across the platform and build custom applications for workflows specific to their organization.
Pre-Built Modules
Resolve appeals. Track regulatory changes. Prepare audit universes. Manage delegated entities. Six modules for the workflows that consume the most staff hours.
Usher AI
The compliance engine that makes the platform healthcare-aware. Every module, agent, and copilot inherits CMS regulatory logic and payer context from Usher AI.
Build Your Own
When a workflow is specific to your organization, your team builds the application themselves. Low-code/no-code. Same infrastructure. Full access to Usher AI.
Pre-Built Modules
Start With the Problem You Need to Solve First
Each module ships with CMS compliance logic and Usher AI built in. Deploy one module to address an immediate need. Add more over time. All modules share data natively, so nothing gets re-implemented.
Appeals & Grievances
Reduce intake processing time by half. Automates classification, routing, and resolution tracking for appeals, grievances, and provider disputes across all lines of business.
Learn moreRegulatory Compliance
Cut regulatory monitoring from 10+ hours a week to under two. Tracks CMS, HPMS, and state updates. Manages policies, corrective action plans, COI disclosures, and incident management.
Learn moreAudit Management
Prepare for CMS audits in days, not weeks. Automates evidence assembly, finding categorization, CAP generation, and response packaging for program audits and mock audits.
Learn moreUniverse Management
Reduce universe prep from six to eight weeks to under one week. Generates, scrubs, and aggregates CMS audit universes with built-in validation rules.
Learn moreDelegation Oversight
Know which delegates are meeting SLA requirements and which are not. Tracks performance, automates attestation collection, manages CAPs, and keeps documentation audit-ready.
Learn morePart C & D Reporting
Submit Part C and Part D reports with fewer errors and less manual effort. Pre-built CMS templates automate data collection, validation, and submission tracking.
Learn moreUsher AI
Why Every Module Understands CMS Regulations
Usher AI sits underneath the platform. It includes two purpose-built engines, a Compliance LLM and an Operational LLM, that give every module, agent, and copilot CMS regulatory awareness. That is why search results cite the right rules, why agents enforce timeliness requirements, and why copilots answer with regulation-level traceability.
Compliance LLM
Validates data against CMS and plan-specific regulatory standards. Provides citation-level traceability.
Operational LLM
Automates routing, classification, and conditional workflows. Detects bottlenecks before they escalate.
AI Agent Studio & Copilots
Pre-built agents and copilots for intake, regulatory notices, audit management, and custom use cases.
Compliance intelligence powering all modules, agents, and copilots
Build Your Own
Your Plan Has Workflows No Vendor Has Built a Module For
Credentialing tracking. Provider network adequacy reviews. Internal compliance attestation campaigns. Every health plan has processes that are specific to how they operate.
The low-code/no-code builder lets your compliance and operations teams create those applications on the same platform, with the same data, the same governance, and the same Usher AI compliance engine. No IT tickets required.
- Low-code/no-code builder accessible to non-technical teams
- Shares data natively with all pre-built modules
- Usher AI compliance intelligence available to custom apps
- Same HIPAA-compliant, HITRUST-certified infrastructure
- Role-based access controls and full audit trails
Build Your Own
Build it without IT.
Your operations or compliance team configures forms, workflows, dashboards, and reports in the low-code interface.
Map the process.
Identify what your team does manually today. Define data sources, routing rules, and escalation triggers.
Connect to what you already use.
The new app shares data with A&G, Compliance, Audit, and every other module on the platform.
Go live with governance.
Role-based access, audit trails, and Usher AI compliance intelligence are included automatically.
Representative Outcomes
What health plan leaders report
after deploying the Health Cloud platform.
Quotes represent composite feedback from Inovaare customers. Individual results vary.
FAQs
Questions health plans ask
about the Health Cloud platform.
Inovaare’s Health Cloud is a SaaS platform built for U.S. health plan compliance and operations. It includes six pre-built modules (Appeals and Grievances, Regulatory Compliance, Audit Management, Universe Management, Delegation Oversight, and Part C and D Reporting), the Usher AI compliance intelligence layer, and a low-code application builder for custom workflows. All modules share data natively and run on HIPAA-compliant, HITRUST-certified infrastructure.
Yes. The platform includes a low-code/no-code application builder that lets health plans create custom applications for any operational or compliance use case not covered by the pre-built modules. Custom applications run on the same infrastructure, share data with existing modules, and have access to Usher AI’s compliance intelligence. Compliance and operations teams can configure workflows without IT dependency.
Usher AI is the compliance intelligence layer underneath the Health Cloud platform. It includes a Compliance LLM and an Operational LLM that give every module, agent, copilot, and search result CMS regulatory awareness and payer-specific context. Usher AI powers the AI Agent Studio, pre-built copilots, smart summaries, and compliance-aware search across every module. It ships with the platform at no additional licensing cost.
The Health Cloud platform supports Medicare Advantage, Medicaid, Commercial, and Special Needs Plans. Regulatory updates are tagged by line of business, workflows route to the appropriate departments, and reports segment by LOB. Health plans operating across multiple programs manage all compliance and operations from a single platform.
No. The platform’s modular architecture lets health plans start with one or two modules and expand as needs grow. Many plans start with Appeals and Grievances or Regulatory Compliance, then add Audit Management, Delegation Oversight, and Universe Management over time. All modules share data natively, so each addition builds on what is already in place.
Yes. The Health Cloud platform runs on HIPAA-compliant, HITRUST-certified infrastructure. Every action across every module is logged with timestamps and user attribution for audit traceability. Role-based access controls restrict data and AI outputs to authorized users.
Generic platforms treat healthcare as one of many industries and require extensive configuration to support CMS-specific workflows. Inovaare’s Health Cloud ships with pre-built CMS compliance logic, HPMS reporting templates, and healthcare-specific workflows out of the box. The Usher AI layer provides CMS regulatory awareness that generic tools lack. Deployment takes weeks instead of the months or years required by horizontal platforms.
See How It Works for Your Plan
30-minute walkthrough configured for your specific compliance and operations challenges. We will show you the modules, Usher AI, and the application builder.
No commitment. 30-minute walkthrough with your workflow.
Or call 408.850.2235