Inovalon Provider Cloud

Patient Claims & Billing

All-Payer Revenue Cycle Management

Keep revenue flowing with a powerful tool that helps staff focus on real-time eligibility checks, claims status tracking and simple payment posting for both government and commercial claims.

Medicare Revenue Cycle Management

Automate your Medicare billing management with specialized software that corrects complex and multi-step claims, flags receivables at risk and allows you to perform easy eligibility look-ups.

Patient Payment

Patient Payment Management is a comprehensive patient payment software that enables you to capture more revenue and improve patient satisfaction.

Revenue Cycle Management Analytics

Improve first-pass yield on all claims. Inovalon All-Payer RCM Intelligence delivers analytic dashboards to identify performance trends, enabling decision makers to easily discover, predict, visualize, model, and manage data all in one application.

All-Payer Claims Management

Our easy-to-use electronic claims management application allows users to submit, edit and receive claims for Medicare, Medicaid and thousands of commercial insurance companies – all in one place.

Patient Statements

Inovalon Patient Statement Management software provides your patients easy-to-read breakdowns of outstanding balances, with statements white labeled to your organization.

Medicare ADR Submission

Simplify your process of secure submission, tracking, and reporting for Medicare claim review programs. This specialized software features connectivity to multiple Medicare esMD programs including ADR, RAC Audits, first- and second-level appeals, PERM, CERT, and more.

Medicare Claims Management

Medicare File Submission is a secure claims submission and remittance advice solution, giving you fast, automated processing and payment of Medicare claims.

Patient Access

Patient Registration

Reduce downstream denials and reimbursement delays through accurate patient data collection at intake. Empower staff to validate patient identity, verify eligibility, and identify all available insurance coverage, all within a few steps powered by a single patient registration software application.

Healthcare Insurance Coverage Discovery

Insurance Discovery reduces uncompensated care and underpayments by identifying active billable coverage previously unknown to the provider. Using sophisticated search capabilities, this solution identifies if patients have multiple active payers to help boost reimbursement opportunities.

All-Payer Health Insurance Eligibility Verification

Eligibility Workflow streamlines patient access and billing workflows by enabling staff to assign and prioritize patients, payers, and tasks during eligibility verification. This technology goes beyond basic eligibility needs, providing a dashboard to confirm, manage, and store every inquiry.

Healthcare Propensity to Pay

Realize the power of patient identity verification combined with custom propensity to pay scoring in one easy-to-use, cloud-based healthcare application. Lower the risk of uncompensated care and collect more revenue with more patient data readily available to make better-informed billing decisions.

Medicare Eligibility Verification

Get fast, detailed eligibility status and medical benefit information, without the hassle of juggling multiple login IDs and passwords. Eligibility Verification Medicare software enables you to submit inquiries 24/7 and receive real-time responses.

Medicare DDE/FISS Connectivity

Direct Data Exchange Verification delivers secure, online connections for Part A and Part B providers. If you need connectivity to DDE through the Professional Provider Telecommunication Network (PPTN), Regional Home Health and Hospice Intermediary (RHHI), or Claim Status Inquiry (CSI), we have you covered.

Patient Engagement

Telehealth

Inovalon’s Virtual Care software is user-friendly, reliable, and built by a team of healthcare experts with the full patient journey in mind. The solution easily integrates with eligibility, claims, and patient payment tools powered by the Inovalon ONE Platform, so you can bring key care delivery functions into one place.

• Chocta Nation Health Care Center (OK)
• Guardian Angels Senior Services
• Marshall Medical Center (CA) 
• Phelps Memorial Health Center
• Quality Care ER (TX)