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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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
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
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
Inovaare Platform
Centralize critical data to meet government healthcare programs and commercial health-plan compliance requirements.
- Achieve compliance program effectiveness (CPE) objectives
- Ensure CMS Program Audit compliance
- Generate universes for Medicare, Medicaid and Commercial plans with the touch of a button