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Revenue Cycle Management Analytics Software
An RCM analytics solution that identifies exactly where revenue leakage is occurring in real time and facilitates more consistent, predictable cash flow.
RCM Intelligence, Powered by the Inovalon ONE® Platform
Provide financial leaders with end-to-end visibility across the revenue cycle. Improve cash flow and productivity with actionable intelligence to reduce accounts receivable.
Overview
Improve first-pass yield on all claims. Inovalon RCM Intelligence delivers analytic dashboards to identify performance trends, enabling decision makers to easily discover, predict, visualize, model, and manage data all in one application.
Real-time RCM insights
Pair claims data, remittance data, and more to understand the real-time health of your revenue cycle – allowing your organization to take immediate action.
Performance management analytics
Quickly understand how your revenue cycle is operating and performing, arming executives with the data they need to truly understand organizational financial outcomes.
Scorecard dashboards
Use scorecards to track revenue cycle improvements, see where workflow challenges may exist, and find root causes with the ability to drill-down into specific claims, if needed.
Benefits
Improve speed to payment by easily monitoring payer and payment trends to gain the insights you need to make well-informed business decisions.
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Accelerate cash flow
Improve first-pass yield on all claims with actionable insights into primary denial-causing categories. Reduce denials by identifying opportunities to improve eligibility, coding, and custom edit workflows.
Strengthen denial prevention
Leverage pre-built, automated reporting to predict denials and take action to avoid them. Empower leaders to make strategic decisions with cash flow projections and intelligent insights on where to focus their efforts.
Improve payer relations
Enable more productive negotiations with a comprehensive view into payer or financial class-specific denials, reimbursements, and turnaround times.
Enhance RCM efficiency
Equip staff with visualization into repetitive tasks that can be automated -- saving time, boosting productivity, and offering satisfaction beyond just a paycheck.
How it Works
Improve first-pass yield on all claims and easily monitor your revenue cycle from end to end with real-time access to performance data.
Better analytic insights for better RCM performance.
Inovalon RCM Intelligence is an integrated analytics software solution for any clearinghouse that delivers proactive insights into the health of your revenue cycle.
Built with 12 pre-configured, intuitive dashboards, this product gives you the tools to identify exactly where revenue leakage may be occurring with end-to-end workflow visibility to performance insights.
Performance management dashboards create at-a-glance views of how well your revenue cycle is operating, while scorecard dashboards deliver high-level data reports and the ability to get claim-specific information if needed. Together, the various views enable continuous workflow improvements at every step of the revenue cycle, empowering decision-makers to act faster with more information at your fingertips.
These are the insights your organization needs to better manage the entire revenue cycle in a simple, straightforward way.
Real-World Applications
For CFOs, COOs, or any other healthcare financial leader, Inovalon RCM Intelligence provides access to the performance data needed to improve cashflow.
Hospitals and health systems
Uncomplicate billing processes with detailed claims and remittance data to better drive desired payment outcomes.
Skilled nursing facilities and home health agencies
Manage complex claims and lower days in A/R with better visibility to revenue cycle delays and denials – and how to proactively address them.
Provider organizations
Simplify RCM reporting and stay on top of revenue cycle areas of leakage with real-time performance data.
Billing services
Harness untapped RCM data to help providers collect the correct reimbursement, faster.
Software vendors
Empower providers with KPIs that are directly tied to financial goals like improving payment turnaround times and accurately predicting cash flow.
Product Sheet
Frequently Asked Questions
What is revenue cycle analytics?
Revenue cycle analytics help healthcare financial leaders assess the overall health of their revenue cycle, from patient access to claims and billing. Inovalon RCM Intelligence provides actionable analytics and business intelligence into payment and payer trends through 12 performance dashboards and easy-to-read score cards.
How is revenue cycle performance measured in RCM Intelligence?
The application provides access to multiple dashboards including First-Pass Yield, Cash Projection, Performance, Payer Score Card, Claims Statistics, Denial Score Card, Edits Score Card, User Productivity, Claims Billed Summary, Reimbursement Details, Adjustment Claims, RTP Report, and more. To see a dashboard demonstration of the available analytics, please contact us.
I have a 99% clean claim rate. How can I improve beyond that?
For years, clearinghouses have boasted stellar clean claim rates, us included. However, the real impact to your organization is whether a claim gets reimbursed. Inovalon is the first clearinghouse to measure and provide actionable insights to help you improve payment percentage on first submission.
I already have analytics capabilities in my EMR/clearinghouse. Why would I need anything more?
Not every claim is paid on first submission, but high-performing providers can improve their first-pass acceptance with the right insights. We target less than 5% of claims not paid on first submission. Our analytics dashboards provide actionable insights on how to improve performance, reducing your time to cash and the amount of rework your billers must complete.
My billers are very effective at finding edits needed and correcting claims before they go out the door. Why do I need analytics?
We have found that billers are very effective at finding edits needed over time. However, by building custom business rules, you can reduce the amount of time they spend on repetitive edits and give them more time to work on other issues. Additionally, as payer rules change, we can flag the initial denials sooner so you can react faster.
How can denial data help me if my issues start before billing?
In addition to claim, remit, acknowledgement, and RTP data, we can also accept data from your EMR. We can then pinpoint sources of issues like physicians, coders, and specific departments that may need to improve their procedures.
Overview Video
1Inovalon internal reporting, ABILITY EASE® All-Payer, November 2020.
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