Audit Universe Management System
Universe files that pass CMS review. Every submission cycle.
The end-to-end system that generates, curates, scrubs and aggregates CMS universe files, so your team can generate and submit clean data without an IT ticket queue for every audit cycle.
The Challenge
Universe data quality issues frequently surface as conditions and observations.
When schema errors, missing fields and timeliness violations surface during CMS review, the cost of remediation is highest and the audit scope can expand.
submission
Errors discovered after CMS review
Schema errors and format violations surface during CMS review, expanding audit scope, triggering resubmission cycles, and in serious cases, Civil Money Penalties.
weeks of manual effort
Weeks of manual validation every cycle
Compliance teams spend weeks manually reviewing universe files against CMS protocols. The process is error-prone, IT-dependent, and challenging to scale.
bottleneck
IT involvement required every cycle
Generating universe files from claims, authorizations and grievance systems requires IT at every submission. Compliance teams cannot self-serve.
aggregation
No consolidation across delegates
Plans with multiple FDR/DE entities receive universe files in different formats. Consolidating them into a single CMS-compliant submission requires manual reconciliation.
Trusted by Health Plans
Health plans trust Inovaare for universe management across MA and Medicaid lines of business.
Before vs. After
From manual validation to automated compliance
| Activity | Manual Process | With Inovaare UMS |
|---|---|---|
| Data Generation | IT-dependent extraction from multiple source systems; weeks of lead time per cycle | Self-service universe generation with automated extraction and CMS-compliant formatting |
| Format Validation | Manual review against CMS protocol documents; schema errors found by CMS reviewers | Automated schema and format scrubbed against current CMS Protocols |
| Error Remediation | Generic error reports; no guidance on root cause or corrective action | Field-level remediation guidance with prioritized error reports; compliance staff resolve flagged items directly |
| Multi-Entity Files | Manual reconciliation of FDR/DE files in different formats | Automated aggregation into a single CMS-compliant file with full audit trail |
| Protocol Updates | Weeks or months of lag after CMS publishes changes | New Draft Protocols auto-integrated, zero lag between CMS update and validation rules |
| Audit Readiness | No visibility into submission history or error trends | Compliance dashboards with drill-down views, error trending and submission history |
Operational Impact
Measurable outcomes from health plans using UMS
Universe prep reduced to under 1 week with the full pipeline
Based on client implementations
Faster universe creation: ODAG, CDAG, SARAG, SNP-MOC
Medicare Advantage Program Audits
IT tickets required for universe generation or self-service reporting
Low-code/no-code platform
Of universe fields scrubbed against current CMS schema before submission
Pre-submission checklist coverage
How It Works
Four components. One governed pipeline.
Raw operational data goes in. A scrubbed, CMS-compliant universe file comes out. Every step is automated, auditable and updated when CMS changes protocols.
Generate
Raw operational data becomes a structured universe file. No IT tickets, no manual extraction. Your compliance team runs it.
Curate
CMS business rules, timeliness logic and inclusion/exclusion criteria applied automatically. Standard errors caught before validation.
Scrub
Every field scrubbed against current CMS New Draft Protocols. Errors flagged with specific remediation instructions, not generic reports.
Aggregate
Files from multiple entities consolidated into one CMS-compliant submission. Full audit trail on every record, every correction.
Universe Scrubber
The CMS pre-submission validator built for Medicare Advantage.
Purpose-built for CMS Program Audits, the Universe Scrubber scrubs and flags errors in your universe files against current CMS audit protocols before they ever reach a CMS reviewer.
Submit clean universe files on every CMS Program Audit cycle.
The scrubbing engine that sits between your data and CMS. It checks every field against current protocols, tells your team exactly what to fix and logs every action for audit defense.
CMS Program Audit Coverage
- ODAG
- CDAG
- SNP-MOC
What the Universe Scrubber does
Comprehensive error detection & flagging
Identifies schema, format, and data quality errors across all universe fields. Flags every non-compliant record with specific remediation instructions.
Field-level remediation guidance
Prioritizes error reports with specific field-level instructions. Compliance staff knows exactly what to fix, no interpretation required.
New Draft Protocol auto-updates
When CMS publishes updated protocols, scrubbing rules update automatically. Zero lag, zero manual reconfiguration between CMS releases and your readiness.
Full audit trail on every action
Every scrub, error correction, and human review decision is logged, version-controlled, and exportable, providing defensible evidence for CMS auditors.
Email alerts for human review items
Errors that require human judgment trigger role-based email notifications. Reviewers act directly from their inbox with context and guidance attached.
Why Inovaare
A governed pipeline, not a point tool.
Many plans rely on standalone scrubber tools or manual spreadsheet processes. Inovaare provides a complete, automated universe pipeline with structured validation and human-in-the-loop review at every step.
Standalone Scrubbers & Manual Processes
- Validate only, no generation, curation, or aggregation capabilities
- No modular expansion path, cannot add Medicaid, Part C&D, A&G, or custom data quality scrubbers over time
- Protocol updates require manual reconfiguration after each CMS release
- No integration with audit management or corrective action systems
- Limited audit trail with no version control or exportable evidence for CMS defense
Inovaare Universe Management System
- Full four-component pipeline: Generator + Curator + Scrubber + Aggregator in one governed system
- Core platform covers Medicare Advantage CMS Program Audits (ODAG, CDAG, SNP-MOC); add-on scrubbers available for Medicaid, Part C&D, and Call Log
- New Draft Protocols integrated on release, no manual reconfiguration cycle between CMS updates and your next submission.
- Connects to Inovaare's broader platform, validated universe data can feed audit management and corrective action workflows
- Full audit trail on every action, decision, and correction, logged, version-controlled and exportable for audit defense
Getting Started
Ready to see your universe data scrubbed in real time?
Walk through your current universe process with our team. We will show you how UMS handles your specific audit types and data sources.
Extend Your Pipeline
Add-on scrubbers for additional programs
The core Universe Scrubber covers Medicare Advantage CMS Program Audits. Health plans with additional programs or lines of business can expand with purpose-built add-ons.
Medicaid / Medi-Cal Scrubber
State-specific encounter data validation for California Medi-Cal and other Medicaid programs. Adapts to each state’s format requirements and compliance checks.
Call Log Scrubber
Scrubss call log data against CMS timeliness and content requirements. Catches callback, hold time, and resolution data errors before submission.
Part C & D Scrubber
Scrubs HPMS Part C and Part D reporting data against CMS schema requirements. Integrated with the Part C&D Reporting module for end-to-end submission management.
A&G Universe Scrubber
Scrubs Appeals & Grievances universe files for timeliness, acknowledgment compliance, and data completeness. Natively linked to the A&G module for traceability.
Custom Scrubbers
Configurable business rules layer for plan-specific data quality requirements. Adapts to your operational data structure — deployed in days, not months.
Resources
Evaluate on your timeline.
Self-Serve
Readiness Assessment
This is not a checklist of audit tasks. It evaluates your end-to-end data readiness maturity.
Start assessment
On-Demand
Recorded Product Walkthrough
Watch a 30-minute overview of the platform at your own pace. Share with your evaluation team.
Watch now
Download
CMS Program Audit Readiness Playbook
This playbook shows you how to move from reactive to proactive readiness, with practical guidance and technology-enabled solutions.
Request eBook
FAQ
Questions health plans ask about
universe management.
Most health plans are live within 6–8 weeks depending on the number of data sources and scrubber configurations. The Scrubber module can be deployed independently in as few as 2 weeks. No custom development is required — the platform is low-code/no-code and configurable by compliance staff.
Yes. The Universe Generator connects to standard health plan data sources including claims, authorizations, appeals, grievances, and FDR portals via secure file transfer, API, or database connection. The platform is designed to layer onto existing systems with minimal disruption.
Yes. Inovaare’s Health Cloud Platform is HIPAA compliant and HITRUST certified. All data is encrypted in transit and at rest. The platform maintains comprehensive audit logs and supports role-based access controls aligned with healthcare compliance requirements.
Yes. Many health plans begin with the Universe Scrubber for immediate validation capability and expand to the full pipeline over time. Each component — Generator, Curator, Scrubber, and Aggregator — can be deployed independently or as a complete system. Modular pricing supports a phased approach
When CMS publishes New Draft Protocol updates, Inovaare integrates the changes into the validation rules automatically. Your team does not need to manually reconfigure scrubber rules or wait for a vendor update cycle. This eliminates the compliance lag that creates audit risk between CMS updates and plan readiness.
Inovaare uses modular pricing — each UMS component (Generator, Curator, Scrubber, Aggregator) and add-on scrubber can be purchased separately or as a bundle. Many plans start with the Scrubber and expand over time. Enterprise pricing is provided upon request based on your plan’s size and configuration needs.
The core Universe Scrubber supports Medicare Advantage CMS Program Audits: ODAG, CDAG, and SNP-MOC. Add-on scrubbers are available for Medicaid/Medi-Cal, Part C and D reporting, Appeals and Grievances universes, and Call Log data. Custom scrubbers can also be configured for plan-specific data quality requirements beyond standard CMS programs.
How audit-ready is your universe process?
See how Inovaare UMS reduces universe prep from 6–8 weeks to under one week with traceable, auditable at every step.
No commitment. 30-minute walkthrough with your workflow.
Or call 408.850.2235