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Description
Inovaare stands at the forefront of health plan solutions that facilitate digital transformation within the healthcare sector, providing automation for intricate workflows related to Medicare, Medicaid, and Commercial appeals and grievances (A&G), as well as Compliance Program Effectiveness (CPE). Their versatile cloud-based modules gather real-time data from various internal and external departments, culminating in a unified compliance management system. With adherence to HIPAA regulations, the platform incorporates the latest and most effective regulatory processes, enabling health plans to address their specific business needs, maintain audit readiness, mitigate non-compliance risks, and reduce overall operational expenses. By automating labor-intensive manual compliance tasks, Inovaare’s leading Appeals & Grievances and Regulatory Compliance solutions enhance CMS reimbursements, lower compliance audit risks, and decrease operating costs. The software is adaptable, enhancing risk identification, bolstering operational efficiency, and presenting user-friendly analytics for better decision-making. This innovative approach not only streamlines processes but also empowers healthcare organizations to navigate complex regulatory landscapes with greater confidence and agility.
Description
To mitigate potential risks, the Centers for Medicare and Medicaid Services (CMS) have instituted guidelines to ensure the validation of their networks. Given that Pharmacy Benefit Managers (PBMs) are significantly impacted by the risk assessment process, the demand for precise and actionable insights has reached unprecedented levels. The LexisNexis Provider Integrity Scan streamlines a variety of provider verification processes and offers continuous monitoring by cross-referencing numerous files and lists, while also delivering automatic alerts for numerous high-risk factors. This tool is proficient in screening and verifying providers both before and after enrollment, aiming to uncover and thwart criminal activities effectively. By identifying potentially fraudulent providers and businesses involved in health-related programs, the LexisNexis Provider Integrity Scan serves to lower costs for health care payers and PBMs alike. Our innovative solution empowers users to effectively conduct multiple searches and access crucial information, enhancing their operational efficiency and security. This comprehensive approach not only safeguards the integrity of health care programs but also fosters a more reliable health care environment.
API Access
Has API
API Access
Has API
Pricing Details
No price information available.
Free Trial
Free Version
Pricing Details
No price information available.
Free Trial
Free Version
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Vendor Details
Company Name
Inovaare
Founded
2006
Country
United States
Website
www.inovaare.com
Vendor Details
Company Name
LexisNexis
Founded
1970
Country
United States
Website
risk.lexisnexis.com/products/provider-integrity-scan