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Average Ratings 0 Ratings

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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 No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

Aerial Yes 
Rackspace Cloud Files Yes 
XML No 

Integrations

Aerial No 
Rackspace Cloud Files No 
XML Yes 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Types of Training

Training Docs Yes 
Webinars Yes 
Live Training (Online) Yes 
In Person Yes 

Types of Training

Training Docs Yes 
Webinars Yes 
Live Training (Online) Yes 
In Person Yes 

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

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Product Features

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