Highlights
Driving Health Plan Compliance Automation Through a Next-Generation Universe Management System
182,889
in annual operational savings
196,801
errors identified
99%
Reduction in error detection turnaround
50%
reduction in efforts for file aggregation and consolidation time
The Situation
A leading nonprofit health plan based in Arizona set out to transform its regulatory reporting with a focus on health plan compliance automation. Their goals:
- Increase data accuracy
- Accelerate reporting turnaround
- Enable seamless data aggregation across system
Inovaare’s Universe Management System is far ahead of anything else we evaluated. Their command over CMS audit requirements gave us confidence that we weren’t just implementing a tool, we were partnering with a team that understands compliance inside out. That’s what makes them more than a vendor, they’re a strategic compliance ally.
Director of Compliance
The Challenge
The health plan faced three key challenges in modernizing its regulatory reporting process:
- Manual error detection slowed down turnaround times and increased audit risk
- Data aggregation was complex, with inputs scattered across multiple disconnected sources
- Non-standardized data collection from internal teams caused further delays in report submission
The Solution
To modernize its regulatory reporting process without delay, the health plan chose Inovaare’s Universe Management System (UMS), a cloud-based health plan compliance automation solution purpose-built for CMS reporting. UMS streamlines the creation, validation, and submission of CMS universes with speed and accuracy.
- Automated universe file processing in just a few clicks
- Intelligent error extraction and categorization for faster resolution
- A centralized framework to consolidate data from multiple sources, accelerating audit readiness
- Enterprise-wide reporting that enhances visibility and accountability
The Impact
After going live with Inovaare’s Universe Management System, the health plan quickly realized the advantages of moving away from fragmented tools and manual reporting processes. The UMS platform offered an end-to-end solution for CMS universe file preparation, monitoring, and audit readiness, all within a centralized, automated, and cloud-based environment. With built-in compliance logic and real-time error detection, the platform not only accelerated operational turnaround but also improved data consistency across departments. What once took days of back-and-forth coordination and error reconciliation was now completed in minutes with fewer touchpoints and greater accuracy.
Key impacts included:
- Improved audit readiness through real-time monitoring and faster universe submission cycles
- Faster response turnaround, reducing delays during audits and internal reviews
- Streamlined data aggregation, enabling quick universe creation from distributed sources
- Early compliance risk identification with automated validation and error categorization
- Actionable insights through Timeliness Dashboards for proactive audit management
- Cross-functional alignment enabled by standardized data collection and reduced manual back-and-forth
Explore Inovaare
Inovaare is a healthcare compliance and operations platform purpose-built for Medicare, Medicaid, and Commercial health plans. Our cloud-based solutions empower payers to automate complex processes across governance, risk, compliance (GRC), appeals and grievances, audit readiness, delegated oversight, and more.
With a focus on health plan compliance automation, Inovaare helps reduce manual effort, improve regulatory reporting accuracy, and enhance audit outcomes. Our HIPAA-compliant, HITRUST-certified health cloud platform for payers includes pre-built modules, AI-powered copilots, and a low-code builder to scale digital transformation without disrupting legacy systems.
Trusted by leading health plans across the U.S., Inovaare delivers the technology, data control, and compliance logic payers need to stay ahead, every audit cycle, every regulation, every time.