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What is Inovalon Claims Management Pro?

Achieve a consistent revenue flow by leveraging a powerful platform designed to expedite reimbursements through eligibility checks, claims status monitoring, audit and appeal processes, and remittance management for both governmental and commercial claims, all within a unified system. Benefit from an advanced rules engine that swiftly corrects claims in alignment with the latest regulations from CMS and commercial payers, enabling you to fix any errors before submission. During the claim upload procedure, verify eligibility with all payers and pinpoint any issues that require attention, allowing for essential modifications prior to dispatching the claims. Decrease the days in accounts receivable by utilizing automated workflows to manage audit responses, submit appeals, and oversee administrative dispute resolutions efficiently. Customize staff workflow tasks according to the type of claim and the actions needed for resolution. Moreover, automate the process of submitting secondary claims to avoid the risk of timely filing write-offs. Ultimately, improve your claims revenue through streamlined workflows that support faster and more effective audits and appeals, ensuring your organization remains financially robust. Additionally, the adaptable nature of this comprehensive system allows it to grow alongside your operations, providing sustained advantages over time. This flexibility not only enhances operational efficiency but also prepares your organization for future changes in the healthcare landscape.

What is Aithent?

Both large and small organizations turn to Aithent for its expertise and solutions to tackle their operational challenges while achieving their digital transformation goals. By optimizing operational processes, Aithent is instrumental in mitigating risks associated with fraud, anti-money laundering, and a range of disputes. The company's innovative use of technology has led to marked improvements in efficiency and overall performance. A notable tool, the Aithent Dispute Manager, ensures a standardized investigation process across various branches and call centers, thereby protecting your institution's brand reputation no matter the location. This cohesive strategy not only enhances operational flow but also strengthens the trust of clients and stakeholders, fostering a more reliable business environment. As a result, organizations using Aithent can navigate complexities with greater confidence and agility.

Media

Media

No images available

Integrations Supported

Inovalon Provider Cloud

Integrations Supported

Inovalon Provider Cloud

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

Inovalon

Date Founded

1998

Company Location

United States

Company Website

www.inovalon.com/products/provider-cloud/revenue-cycle-management/all-payer-revenue-cycle-management/

Company Facts

Organization Name

Aithent

Date Founded

1991

Company Location

United States

Company Website

www.aithent.com

Categories and Features

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

Categories and Features

Electronic Medical Records (EMR)

Appointment Management
Charting
Compliance Tracking
E-Prescribing
E/M Coding
HIPAA Compliant
Handwriting Recognition
Integrated Telehealth
MIPS Certified
Meaningful Use Certified
ONC-ATCB Certified
Patient Portal
Self Service Portal
Voice Recognition

Fraud Detection

Access Security Management
Check Fraud Monitoring
Custom Fraud Parameters
For Banking
For Crypto
For Insurance Industry
For eCommerce
Internal Fraud Monitoring
Investigator Notes
Pattern Recognition
Transaction Approval

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

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