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What is Inovalon Payer Cloud?

Enhancing clinical quality metrics, refining the accuracy of risk assessments, increasing engagement from both patients and providers, improving patient outcomes, ensuring transparency in operations, and maximizing financial performance can all be accomplished through a cohesive suite of software solutions. The Inovalon Payer Cloud transforms traditional workflows into innovative, data-driven processes that align seamlessly with the core objectives of your health plan. With its robust analytics capabilities, our integrated SaaS offerings deliver critical insights focused on member needs, alongside the speed, accuracy, and flexibility necessary to thrive in today’s diverse and fast-paced market. By utilizing Inovalon's healthcare payer SaaS suite, organizations gain not only invaluable insights and actionable strategies but also the empowerment to evaluate, manage, and improve health outcomes, economic viability, and overall care quality. Our payer solutions enable stakeholders to foster enhanced member care and outcomes while concurrently boosting operational performance and efficiency, utilizing cutting-edge analytics and nimble business intelligence tools to adeptly maneuver through the complexities of the healthcare environment. Consequently, organizations can establish a proactive healthcare management strategy, ensuring they are prepared to tackle both present and future challenges effectively while maintaining a focus on continuous improvement. This forward-thinking approach not only enhances patient satisfaction but also drives overall organizational success in the healthcare sector.

What is HealthRules Payer?

HealthRules® Payer is a state-of-the-art core administrative processing framework that delivers transformative capabilities for health plans of all shapes and sizes. For more than ten years, health plans that have adopted HealthRules Payer have successfully seized market opportunities and sustained a competitive advantage. What distinguishes HealthRules Payer from other core administrative systems is its unique utilization of the patented HealthRules Language™, which closely resembles English and introduces an innovative approach to configuration, claims management, and transparency of information. This exceptional system empowers health plans to grow, innovate, and excel beyond their competitors more efficiently than any other core solution currently available. Consequently, HealthRules Payer not only enhances operational efficiency but also cultivates a culture of adaptability and responsiveness within health organizations, ultimately leading to improved patient care and satisfaction. By integrating advanced tools and methodologies, HealthRules Payer positions health plans to thrive in an ever-evolving healthcare landscape.

Media

Media

Integrations Supported

Inovalon ONE Platform

Integrations Supported

Inovalon ONE Platform

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

Company Location

United States

Company Website

www.inovalon.com/products/payer-cloud/

Company Facts

Organization Name

HealthEdge Software

Company Website

www.healthedge.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

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

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