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All-Payer Revenue Cycle Management Software
Speed up reimbursements and strengthen revenue with eligibility, claims, audits and appeals, and remittance management – all in a single system.
Claims Management Pro, Powered by the Inovalon ONE® Platform
This valuable all-payer revenue cycle management software can reduce claims denials by improving your clean claims, averaging a rate of 99% or better.
Overview
Keep revenue flowing with a powerful tool that helps staff focus on real-time eligibility checks, claims status tracking and simple payment posting for both government and commercial claims.
Improve clean claims
Access scrubbers that contain the most up-to-date CMS and commercial payer rulesets and can be optimized for your organization.
Simplify eligibility checks
Verify eligibility across all payers during claim upload; errors are flagged so claims can be edited before submission.
Streamline claims resolution
Decrease days in A/R with automated workflows for audit responses, appeal submission and ADR tracking.
Benefits
Strengthen claims management results, while making the process more efficient and productive across Medicare, Medicaid and commercial payers, with Claims Management Pro.
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Know in advance
Plan for cash flow with revenue forecasting.
Detect patterns
Identify denial trends with advanced analytics and reporting.
Prevent write-offs
Automate secondary claims submissions to stop timely filing write-offs.
Enhance audits and appeals
Increase claims revenue with automated workflows for faster, more successful audits and appeals.
Speed up posting
Access and download ERAs with one login for accelerated payment posting.
How it Works
Access a comprehensive all-payer revenue cycle management software that far outpaces the average clearinghouse.
Take the direct route to a stronger revenue cycle through gold-standard clean claims of 99% or better.
The continuing shift in reimbursement from volume to value means providers need to create efficiency in their revenue cycle to remain profitable. For most organizations, manual processes are the leading contributor to labor overruns and create errors that cost time, money and result in patient dissatisfaction.
With Claims Management Pro, you can maximize efficiency through instant, clear claims information displayed on intuitively designed dashboards. It’s the simple way to increase accuracy by lowering the chances of human errors. If a claim is rejected by a payer, it is immediately routed to a work queue with clear correction guidance for minimizing days-to-submission.
Product Sheet
Frequently Asked Questions
Does your system automate the secondary claims submission process?
Yes! Secondary claims are submitted automatically.
Does this application help us identify how to correct an error or an issue with the claim?
Yes! The application can help flag and resolve many common claim mistakes before submission and has built-in correction guidance for any issues that need to be reworked after submission.
What type of correction guidance does your system offer?
Our correction guidance includes if/then statements to help staff understand what needs correcting and support them in each step. We also show the rejection message from the payer if working a rejected claim.
Can this application help improve our clean claims percentage?
While every new customer has a different clean claims rate to start, we are confident we can help maintain and improve your clean claims percentage.
Does your system help me identify denials?
Yes, you can focus your work queue on just denials, and work them with confidence using the support of our corrections guidance.
Payer List
Speed up your revenue cycle and reduce A/R days for all your payers with an easy-to-use electronic claims management application that allows users to submit, edit and receive claims for Medicare, Medicaid and thousands of commercial insurance companies.
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Provider Resources
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