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Risk-Score Accuracy Improvement & Submissions

Driving Economic Performance through Advanced Analytics and Point-of-Care Solutions

Our industry-leading risk-score accuracy solutions empower our clients’ successes by leveraging real-world datasets, sophisticated analytics, extensive connectivity and powerful point-of-care technologies to identify and predict patient gaps and improve disease documentation and accuracy.

How we're different

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Unparalleled Dataset: Leveraging our proprietary MORE2 Registry®, we deliver real-time analytic insight to empower our point-of-care solutions, decreasing duplicative member encounters and mitigating audit risk through accurate, timely and compliant submissions processing.

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Large-Scale Connectivity: Inovalon’s extensive connectivity with electronic health records, health information exchanges and more than 170,000 providers enables connectivity to the data of approximately one in every three patients within the United States, increasing speed to value for risk score accuracy improvement initiatives and decreasing provider abrasion by reducing the need to interrupt provider activities. High-speed data integration and security protocols enable rapid solution implementation is as little as two weeks.

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Advanced Real-Time Analytics: Inovalon’s analytics have been informed not only by the subject-matter expertise of leading clinical, regulatory, actuarial, financial and compliance leaders but also from the analysis of data pertaining to more than 45 billion medical events and nearly two decades of experience. Further enhancing these capabilities is the speed with which the analyses are delivered. By undertaking analytics in real time and making available highly connected data sources, data that became available only moments ago can influence the decisions of what to do and where to do it—improving accuracy and avoiding unnecessary efforts.


RAPS, EDS, EDGE Server Submissions

With more than a decade of proven success in risk score accuracy improvement toolsets and RADV programs across all lines of business, Inovalon’s solution supports compliant claims submissions with an average acceptance rate of 98.9% across RAPS, EDS and EDGE Server submissions to deliver a complete, accurate and secure process, mitigating audit risk.

How we're different

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High Acceptance Rates: Inovalon has an average acceptance rate of 98.9% across RAPS, EDS and EDGE Server submissions, an acceptance rate materially higher than many health plan in-house solutions and third-party technology systems. The improvement in submission accuracy and acceptance rates translates into not only greater compliance rates but also millions of dollars in improved financial performance, the elimination of duplicative processes, and a more rapid achievement in financial transparency.

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Regulatory Compliant:  Inovalon’s end-to-end submissions solutions support complaint, accurate HCC submissions, mitigating RADV risk and allowing you to avoid regulatory disciplinary action and provide correct processes going forward.

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Proven Results Delivered On Time: With more than a decade of experience in implementing effective data submission solutions—having never missed a CMS deadline—Inovalon’s solution delivers complete, accurate and secure submissions, on-time, every time.

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Actionable Data Visualization & Reporting: Inovalon’s dynamic data visualization capabilities empower health plans to proactively manage their risk-score data submissions by delivering actionable insights into the financial impact of the claims submitted in order to support an accurate and timely submission process.



Assets

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