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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 BRMS?

BRMS stands out for its ability to process Medical, Dental, Vision, and Retiree claims with both efficiency and accuracy, ensuring quick turnaround times. Each night, we update eligibility through our MyHealthBenefits system to provide the most current information. Our proficiency in negotiating PPO agreements enables us to significantly reduce costs for employers related to claims. We manage the entire claims administration process, from the initial claim receipt and eligibility checks to negotiations and final payments. By consolidating all operations internally—encompassing claims processing, medical management, PPO network oversight, and billing—we provide a tailored and responsive service experience. For self-insured organizations, BRMS proves to be an essential ally in managing Medical, Dental, and Vision claims with remarkable precision and speed. Our dedication to delivering high-quality service and ensuring customer satisfaction distinctly positions us within the industry. Ultimately, our comprehensive approach to claims administration not only streamlines processes but also fosters long-lasting partnerships with our clients.

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

Benefit and Risk Management Services

Date Founded

1993

Company Location

United States

Company Website

www.brmsonline.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

Benefits Administration

COBRA Administration
Claims Management
Deduction Management
Disability Insurance Administration
Employee Benefits Administration
FMLA Administration
FSA Administration
Flexible Spending Accounts
For Brokers
For Employers
HIPAA Compliant
Health Insurance Administration
Life Insurance Administration
Online Benefits Enrollment
Premium Billing
Provider Management
Retiree Administration
Retirement Plan Management

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