How Paramount Healthcare Fixed a Fragmented Revenue Cycle

Running billing for a single skilled nursing facility is complicated enough. For Paramount Healthcare, multiply that by 12.

With hundreds of residents across a dozen facilities, many of whose coverage shifts as Medicare stays expire, the billing team was constantly chasing information. Eligibility checks lived in one system, claims in another, and payment posting required manual entry for each facility every month. It was a 12-day process just to get payments recorded.

Then Paramount Healthcare partnered with Inovalon to unify their approach to revenue cycle management. The impact was transformational.

“Our payments are like night and day,” said Shasta McClary-Brocious, Director of Billing at Paramount Healthcare. “We don’t have to spend time keying in payments anymore. Once payments hit the bank, they flow in overnight.”

Here’s how they got there.

Getting claims right from the start

For SNFs, a clean claim starts long before submission. It starts with knowing exactly who’s covered – whether that’s Medicare, a secondary payer, or Medicaid. At Paramount Healthcare, that first step used to be one of the biggest bottlenecks.

Legacy tools were glitchy, hard to read, and couldn’t keep pace with constant coverage changes. If the billing team didn’t catch a lapse early, denials piled up downstream.

Using Inovalon’s Eligibility Verification Pro™ and Insurance Discovery™, the team now gets a clear picture of coverage across all 12 facilities. They can spot secondary payers, flag lapses before claims go out, and trust what they’re seeing.

That confidence carries through to submission. Before, roughly 40% of claims went out on paper. Today, 90% are electronic through Inovalon’s Claims Management Medicare Pro™, giving the team near real-time visibility into where every claim stands.

“It’s so much easier to read and more robust,” McClary-Brocious said. “It has less issues than other systems I’ve used in the past.”

From 12 days to one

Getting claims out faster only matters if payments come back efficiently. For Paramount Healthcare, that meant fixing payer enrollments and payment posting.

Enrollments used to involve manual steps, inconsistent workflows, and constant follow-up. Now the team handles everything in one place. “It’s a one-stop shop,” McClary-Brocious said. “We go in the same system to initiate enrollments, fill out the paperwork, and get an email when we need to do something.”

The biggest win came with payment posting. Through integration between Inovalon and PointClickCare, payments now flow automatically once funds hit the bank. A task that consumed 12 days now takes one.

Proving the system when it mattered most

The real test came after the pandemic, when every SNF faced a 5-claim probe audit from Medicare Administrative Contractors. Paper-based audits can take 90 to 120 days. And because Medicare pays claims in order, one stuck claim can freeze reimbursements for months.

Paramount Healthcare was bracing for the worst. “We were so concerned,” McClary-Brocious said. “We were prepared for the 5-claim probes to mess up our cash flow.”

Since audit documentation could now be submitted electronically through Inovalon’s revenue cycle software, the team stayed only slightly behind. “Once those claims processed, we were able to get everything back up again,” she said.

Where they are now: Faster payments, fewer headaches

Today, Paramount Healthcare’s billing operation looks nothing like it did before. Eligibility is reliable and claims move electronically. Payment posting that once consumed nearly two weeks now wraps up in a day. And when audits come, the team is ready.

But the biggest change isn’t any single metric. It’s what the billing team can now focus on. Instead of chasing down information across disconnected systems, they can focus on documentation accuracy and ensuring claims truly reflect the clinical needs of their residents.

A unified revenue cycle is within reach

See how Inovalon’s RCM solutions can help you reduce manual work, speed up payments, and stay audit-ready across your skilled nursing facilities.

Read the full customer story | Request a demo

Inovalon and design® and Inovalon® are trademarks of Inovalon, Inc.