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Revenue Cycle Management Analytics Software

Revenue cycle management analytics software that identifies exactly where revenue leakage is occurring in the RCM process, in real-time.

Powered by the Inovalon ONE® Platform

RCM Intelligence provides financial leaders end-to-end visibility across the revenue cycle with actionable intelligence to help you achieve 95% of claims payments in 20 days or less.

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.

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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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Improve first-pass yield

Continuous monitoring of the quality and performance of your organizations claim processing and First Pass Resolution Rate (FPRR).

Operationalize RCM data

Pair claims data, remittance data, and workflow data to understand the real-time health of your revenue cycle.

Make better-informed decisions

Easily discover, predict, visualize, model, and manage valuable revenue cycle data all in one application and take action to correct areas of concern.

Identify risk

Quickly pinpoint the root cause of low performance areas armed with the necessary data to take swift corrective action.

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 analytics software solution that works in conjunction with our clearinghouse, ABILITY EASE® All-Payer, to deliver 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.

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.