Inovalon: A Preferred Partner for Clearinghouse Capabilities and RCM Analytics

KanTime, an EMR vendor, has served the post-acute market including adult and pediatric home care, home health, and hospice providers for many years, delivering a scalable solution to support their clients with end-to-end intake, billing, scheduling, payroll, HR, and clinical documentation.

Some of KanTime’s noteworthy software capabilities are made possible with Inovalon integrations. Together, our integrated solutions help post-acute providers focus on their most important task – delivering high-quality patient care.

Medicare eligibility is often a messy process. Coverage can change, it may not be the only type of coverage a patient has, and the process to verify Medicare coverage is usually in the manual, error-prone “green screen,” otherwise known as Direct Data Entry (DDE).

With Inovalon’s Claims Management Medicare Pro, KanTime users can replace the standard DDE view with a much easier‑to‑understand, more user-friendly interface. Lotz shares, “The DDE overlay is very impressive, and the integration supports real-time eligibility and batch eligibility checks.”

The software transforms eligibility checks for KanTime customers. Users can easily run a single eligibility check or perform multiple inquiries at once and get instant results. This empowers intake staff to clearly see whether a patient actually has active coverage with any of the payers listed in the referral for post-acute care.

Eligibility results are automatically integrated with the patient files within KanTime’s EMR. They’re available as a PDF that is loaded into the patient record for future reference. This eliminates the need for manual entry between the RCM software and the patient record; Inovalon’s capabilities simply supply the information needed, and the integration ensures the eligibility information is stored correctly within KanTime. In Lotz’s view, the benefits are clear. “It’s a very cool product and it has a clear ROI to me.”

The time savings and efficiency in eligibility verification add up significantly throughout the claim lifecycle. For Medicare claims and customers using Claims Management Medicare Pro, KanTime users have been able to reduce two-thirds of the keystrokes needed to complete Medicare claims management. This creates a ripple effect of more efficiency – for example, reducing the number of hours required to complete claims management empowers staff to shift their focus to other key needs in the organization such as patient care.

Inovalon’s integrated claims management capabilities empower KanTime users to better address denials, save time in their workflows, and drive continuous improvements informed by RCM analytics.

KanTime users can see denial reason codes and their meaning within their EMR so they can clearly understand actions needed. But with the added capabilities of Inovalon’s denial analytics within their claims management software, KanTime users can pinpoint payers and denial reasons that are most impactful to their bottom line and take the actions needed to affect change. For Lotz, “It’s stunning.”

He adds that our denial prevention capabilities are equally impressive. These features help correct denials before they occur by automatically making any necessary adjustments to the claim, based on specific payer rules and custom configurations within the software. The configuration options against payer rules are very broad, giving users great flexibility to set up this part of the integration however works best for their organization.

“Where Inovalon really shines, though,” says Lotz, “is in the area of denials analytics. You can run analytics within the Inovalon software and it will identify the percentage of times that a certain error has caused a claims denial.” This empowers KanTime users to identify and correct common mistakes within their organization. The analytics deliver the visibility needed to address workflow challenges, and in turn, ensure more first-pass payments of claims.

In addition to the impressive capabilities of KanTime and Inovalon’s software integrations, the hands-on, supportive team at Inovalon makes the partnership stand out.

“Inovalon’s team helps our customers understand the ins and outs of what our integration can do,” shares Lotz. “And they’re available whenever our team needs them as well. I can reach out to someone and say, ‘help me understand this,’ and get a quick response. Inovalon clearly values the relationship with KanTime.”

He adds, “There is just so much that Inovalon brings to the table, I could go on and on. I truly believe that you are a great option for our customers.”