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Case Study:

Partnerships that Yield Value: Leveraging Expertise to Drive Economic Performance

Complete RAPS Submissions = Accurate Reimbursement

In a rapidly changing market, one of the keys to success for any health plan is the ongoing assessment of process improvement opportunities. This is particularly true in relation to claims submissions for risk adjustment given all of the challenges around submitting accurate, complete and timely data to the Center’s for Medicare & Medicaid (CMS). Having trusted tools that will alleviate the burden involved in managing this process can significantly impact performance, delivering accurate reimbursement. In a recent engagement, a large health plan with 100,000+ Medicare Advantage (MA) members and 2.12 million+ Medicaid members solicited the help of Inovalon to supplement the health plan’s existing in-house submissions process—obtaining valuable and actionable data.

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