Inovalon Claims Management Pro vs. Claims Signal

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.

Claims Signal™ is an innovative quality assurance solution for claims, created by Aon and Athenium Analytics, aimed at assisting insurers in identifying high-risk claims at an earlier phase. By enhancing the overall experience for policyholders, this platform has the potential to significantly improve claims indemnity and expenses, with estimates ranging from 4% to 6%. In the current dynamic landscape of insurance, claims teams are under increasing pressure to boost customer satisfaction, optimize workflows, and reduce financial losses. While regular quality audits can successfully uncover the underlying issues and divergences from best practices, the insights gleaned from these evaluations might not be available for weeks or months after a claim has been finalized. Envision having the capability to monitor open claims in real-time and address quality issues proactively before they adversely affect outcomes. The Claims Signal platform employs cutting-edge artificial intelligence to analyze open claims, pinpoint emerging challenges, and generate instant alerts, enabling frontline managers to act swiftly before a claim is resolved. By incorporating predictive analytics along with timely notifications, insurers can potentially decrease claims leakage by as much as 4%, thereby revolutionizing the claims management landscape. This forward-thinking methodology not only boosts operational productivity but also cultivates a mindset of ongoing enhancement among claims teams, ultimately leading to a more responsive and effective claims handling process. As a result, insurers can better align their strategies with customer needs and market demands.