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What is Sophical Solutions?

By concentrating on a select number of premium prices and implementing more competitive pricing strategies, we enhance our capacity to generate additional net revenues. This is accomplished by reducing or removing the gaps between charges and negotiated rates for contracts that include "lesser of" clauses. In addition, we increase net revenues through the detection and recovery of underpayments. Our customized models serve each client effectively, as we refrain from confining their data to a generic software solution. These tailored models achieve high accuracy because we carefully analyze every contract, model all pertinent terms, confirm the alignment between plan codes and insurance products, and perform thorough testing on our models. We consider every reimbursement impacted by price changes, which results in the most accurate predictions available in the industry. Moreover, our pricing methodology is not only defensible but also straightforward and comprehensible for patients, ensuring our pricing structures are logical and appropriately tiered. Ultimately, this comprehensive approach significantly boosts revenue generation while upholding transparency and fairness in our pricing practices, fostering trust between us and our clients.

What is Inovalon Insurance Discovery?

Insurance Discovery improves financial results by identifying previously overlooked billable coverage that healthcare providers might not know about, which reduces both underpayments and uncompensated care. Utilizing sophisticated search capabilities, this tool can uncover situations where patients have multiple active insurance payers, thereby enhancing the potential for better reimbursement. Moreover, it aids in avoiding reimbursement delays and speeds up revenue collection by ensuring that claims are accurately directed to the correct payers on the first submission, attributed to more precise coverage information. When combined with verified demographic data, Insurance Discovery offers dependable insights into coverage and eligibility. This innovative method replaces conventional manual insurance discovery processes with a rapid and exhaustive search that accesses numerous databases within seconds, providing comprehensive and precise coverage details. Additionally, it improves the overall experience for patients and residents by allowing for accurate assessments of out-of-pocket costs, leading to a more positive financial journey. By simplifying these procedures, healthcare providers can devote more attention to patient care rather than getting bogged down by administrative duties, ultimately enriching the quality of service delivered.

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

Sophical Solutions

Company Location

United States

Company Website

www.sophicalsolutions.com

Company Facts

Organization Name

Inovalon

Date Founded

1998

Company Location

United States

Company Website

www.inovalon.com/products/provider-cloud/patient-access/insurance-coverage-discovery/

Categories and Features

Payment Processing

ACH Check Transactions
Bitcoin Compatible
Debit Card Support
Gift Card Management
Mobile Payments
Online Payments
POS Transactions
Receipt Printing
Recurring Billing
Signature Capture

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