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Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
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Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Awards
Differentiators
Keywords
Media
Company details
Covered Lives
Covered Lives

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Categories

Solutions

Description

Product Description:

We offer both Medical and Pharmacy Covered Lives Dashboards to help you navigate challenges associated with an ever-changing payer coverage landscape. The tool allows you to: 

  • View lives at the granularity level you need – State or County
  • See the big picture via the interactive map, charts, and summary tables 
  • Dive deeper with filters and narrow down results by Payers, Plan Types, and States 
  • View all parent – subsidiary relationships 
  • Understand payer – PBM relationships 
  • Export a copy for offline use
About Policy Reporter:

Empower your teams with Policy Reporter's payer documents library, change alerts, and reserach tools. 

Healthcare providers face numerous challenges in navigating the complex U.S. healthcare system:​

  • Keeping up with evolving medical necessity criteria, coverage policies, and billing rules​
  • Understanding and complying with diverse payer policies and prior authorization across commercial and government plans​
  • Efficiently managing revenue cycle processes in a constantly changing reimbursement landscape​
  • Ensuring patient access to necessary care while meeting payer requirements​
  • Minimizing claim denials and optimizing reimbursement​

This causes challenges such as: ​

  • Interpreting and applying complex payer policies consistently across the organization​
  • Reducing administrative burden associated with prior authorizations and claim appeals​
  • Staying current with frequent policy changes that impact reimbursement and patient care​
  • Balancing compliance requirements with operational efficiency​
  • Maximizing revenue while ensuring appropriate utilization of healthcare services​

Policy Reporter empowers healthcare providers to address these challenges by:​

  • Delivering analyst-verified alerts for tracking policy changes customize to your specialties and payer mix​
  • Simplifying access to up-to-date coverage criteria, prior authorization and reimbursement rules​
  • Offering comprehensive research capabilities to comply with key contract and claims rules​
  • Supporting efficient revenue cycle management with targeted insights and tools​

Our solutions reduce administrative burden, streamline reimbursement-related research, and empower your entire team to make informed decisions that improve patient care and financial performance.​​

Product Description:

Innovaccer’s Data Activation Platform, leveraging modern cloud lakehouse architecture, is designed to help organizations rationalize their IT expenditures by driving ROI and realizing cost-saving opportunities within their infrastructure. Its data lake architecture provides more than 200 prebuilt connectors to allow hospitals to onboard and test data. With intelligent algorithms, the platform delivers deep AI- and ML-powered predictive insights to support

hospital operations. It’s one of the most cost-effective data archiving solutions and has a variety of use cases to impact productivity, efficiency, and quality for physicians, care coordinators, and healthcare leaders. 

About Innovaccer:

Innovaccer is the data platform that accelerates care innovation through innovative AI technologies. Innovaccer’s AI-powered healthcare platform unifies patient data across systems and care settings, and empowers healthcare organizations with scalable, modern applications that improve clinical, financial, operational, and experiential outcomes. Innovaccer’s EHR-agnostic solutions have been deployed across more than 1,600 hospitals and clinics in the US, enabling care delivery transformation for more than 96,000 clinicians, and helping providers work collaboratively with payers and life sciences companies. Innovaccer has helped its customers unify health records for more than 54 million people and generate over $1.5 billion in cumulative cost savings. The Innovaccer platform is an industry-leading data and analytics platform, the Best in KLAS CRM solution, and the #1 rated population health technology platform by Black Book

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Use Cases

Description:

Strategic Planning & Business Development Teams

Use Case: Your strategic planning team can use the dashboard to assess regional payer enrollment figures, helping identify high-coverage payers and geographic areas for potential expansion of service lines or partnerships. This data supports informed decisions on resource allocation and growth opportunities.

 

Contract Management Team

Use Case: Your contract managers can leverage payer enrollment data to prioritize contract negotiations with high-enrollment payers, ensuring they are focusing on payers that cover a significant portion of the local patient population. This helps secure better terms and expand patient access to your services.

  

Revenue Cycle Management Team

Use Case: Your revenue cycle team can use the dashboard to identify top payers by enrollment, helping to align resources and focus efforts on resolving issues with payers that represent the largest patient populations. This data-driven approach can streamline claims processes and improve reimbursement rates.

  

Population Health Management Team

 

Use Case: Your population health team can analyze payer enrollment data by plan type and geography to better understand the coverage landscape and identify gaps in patient access. This information can be used to tailor care coordination efforts and improve patient outcomes by targeting interventions based on coverage trends.

 

Provider Relations & Network Development Team

 

Use Case: Your provider relations team can use enrollment figures to evaluate the network strength of key payers in specific regions. This data helps assess which payers to engage for network participation, ensuring alignment with those that have substantial patient coverage in your service areas.

Pediatric use cases:

Same application as above. 

Users:
  • Strategic Planning & Business Development Teams
  • Contract Management Team
  • Revenue Cycle Management Team
  • Population Health Management Team
  • Provider Relations & Network Development Team
Description:

A Texas based was looking for a single source of truth that could
provide insights on their care continuum. The organization deployed Innovaccer’s Data Activation Platform, that helped them establish intact patient records, standardize care processes, and managed to deliver meaningful information. The ACO was engaged with five national and commercial payers, looking after more than 200,000 patients. With data incoming from EHRs at 60+ practices, over 280 physicians, and three labs, the ACO required a holistic view of population health. The ACO had the following data needs:
• Data aggregation and normalization from multiple facilities
• Accurate data segmentation and ensured security
• Interoperability across systems
• Gaps in care monitoring
• Quality and performance measurement

With the help of Innovaccer's platform, the outcomes were:
• Gaps in care bridged for 9,000+ lives by 25 care managers in only 6 months.
• 1 FTE saved for the network within the first month of implementation.
• One-click access to patient records, anywhere in the network.
• Network utilization monitored across 5 measures to optimize the utilization of Emergency Room facilities, Inpatient Admits, Specialist Visits, and High Tech Imaging.
• Quality of care tracked across 20 quality measures and calculated to encourage improvement in the quality scores.
• Over 200,000 patient records streamlined for 60+ practices.

Pediatric use cases:

Innovaccer applications rely heavily on trustworthy data formatted into a master patient index.
DAP’s EMPI engine helps in uniquely identifying members (patients) across disparate healthcare IT systems, as an imperative for any downstream applications. DAP employs a proprietary Bayesian-based flexible matching algorithm that produces an accuracy of more than 96% every time to create a Patient 360 longitudinal view.
Deployment of pediatric solution powered by data ie. pediatric centric, we collect, normalize, standardize data and then through our automated workflows find pediatric-specific care gaps and some of them are:
Well Child Visits (W15)
Child Immunization Status (CIS)
Adolescent Immunization Status (IMA)
Private Duty Nursing (PDN), and more.

This supports our pediatric solution deployment and the data powers downstream applications to show results over 100+ pediatric measures.

Users:

Data Analysts, Administrators, IT Support personnel, Business Analysts, Data Analytics Managers

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, ERP system, Patient portal, Pop health platform, Behavioral health, Community based organizations, ADT, Access +/or revenue cycle, Other

EMR Integration & Relevant Hardware:

Required

EMRs Supported:

Allscripts, Allscripts/Eclipsys, athena, Athenahealth, Azalea Health/Prognosis, Cerner, eClinicalWorks, Epic, GE, Healthland, McKesson, Meditech, NextGen, Other

Hardware Compatibility:

Desktop, Mobile / Tablet (web optimized), Other

Client Types

Awards

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Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:
Innovaccer’s Data Activation Platform (“DAP”) is a leading healthcare data platform that enables healthcare organizations to bring disparate data sources together to conduct analytics, derive insights and then act on those insights through other Innovaccer and 3rd party applications. DAP combines advanced big data technologies to deal with massive healthcare data volumes. DAP unifies disparate silos of healthcare data together using its built-in connectors and visually enabled ETL (Extract-Transform-Load) processes. DAP offers a comprehensive list of data sources to extract data from and is capable of handling a multitude of formats and exchange standards. DAP has pre-built connectors with 60+ EMRs and 200+ healthcare IT vendors, can handle over 15 file formats and 600 data fields, and has 10M+ records in its taxonomy knowledge base. Currently, Innovaccer Offers: - Data Aggregation - Data Standardization - Data Analytics - Patient 360 - SQL query engine - API - Closed Loop Capability
Differentiators vs Competitors:
The Data Curation & Transformation is performed through Innovaccer's data platform, which follows a productized approach for Data Extraction, Aggregation, Normalization, Standardization and Export of data. DAP currently allows integration of 60+ EMR's and 200 + IT vendors and has integrated 75% Major leading EMR's across US Healthcare. Also, innovaccer offers a solution of Interoperability i.e. capable of exporting all the data through various export methods to be chosen.

Keywords

Images

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Videos

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Innovaccer Data Activation Platform_ Accelerating healthcare innovation.mp4

Downloads

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Company Details

Founded in 2014

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