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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 Alaffia?

Alaffia employs a sophisticated AI technology designed to pinpoint fraud, waste, and abuse within intricate healthcare claims, with the goal of preventing and recovering overpayments for both employers and payers. This cutting-edge strategy empowers Alaffia to detect and correct errors in claims before any incorrect payments are made. By engaging with Alaffia, you stand to recover funds that may have been lost due to overpayments on these erroneous claims, which could be costing your organization substantial amounts annually, potentially hundreds of dollars for each employee. Collaborating with Alaffia enables you to effectively mitigate these overpayments and improve your financial results. The Alaffia platform excels at identifying and rectifying billing errors, which is crucial in preventing unnecessary overpayments. Our partnership with your health plan or third-party administrator guarantees a seamless integration process that preserves your members' experience without disruption. Furthermore, our services are structured on a contingency fee basis, meaning you will only pay when we successfully secure savings. We are dedicated to protecting your employees from being billed for services that were never rendered, thus maintaining financial integrity in your healthcare spending. With Alaffia, not only do you minimize expenses, but you also optimize the efficiency of your claims management, ensuring a smoother operational flow. By choosing Alaffia, you take a significant step toward enhancing the financial health of your organization.

Media

Media

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

Alaffia Health

Company Location

United States

Company Website

alaffiahealth.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

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