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A&G Case Study A&G Case Study

California Health Plan Appeals & Grievances Department Achieves No Findings in Medicare and Medicaid Audits Using Inovaare A&G Platform

A California-based health plan with with over 100,000 members has
been serving its community for over 20 years and was
looking for a CMS and CA DHCS/DMHC compliance technology partner
who could help them:

  • Incorporate all regulations into a workflows and rules engine
  • Centralize business processes for managing all member-related
    appeals and grievances cases
  • Track all the member appeals and grievances
  • Create regulatory compliance and analytics reports
  • Integrate evolving federal and state regulations into its system
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