Inovaare Corporation

CMS Program Audit Success Story
This case study illustrates how a Fortune 500 American health insurer revolutionized its audit and compliance processes by implementing Inovaareâ??s Universe Management System (UMS). The automated solution centralized data managementâ??streamlining the collection, review, correction, and aggregation of audit universesâ??and enhanced compliance monitoring with real-time Timeliness Dashboards. As a result, the insurer experienced dramatic improvements in efficiency, achieving up to a 90% reduction in audit review time, a 58% decrease in data scrubbing efforts, and a 67% drop in audit follow-up costs, ultimately ensuring 100% success in CMS audit submissions.

Appeals & Grievances: From Cost Centre to a Strategic Intelligence Unit
For too long, Appeals & Grievances (A&G) have lived in the shadows of healthcare operations, boxed into Compliance, under-resourced, and reactive. Health plans see it as a necessary cost, an obligation to regulators, or a post-service clean-up crew. This eBook makes the case for reimagining A&G, not as a cost centre, but as a command centre. It shows why most plans are missing the bigger picture, and how forward-thinking organizations are transforming A&G into a core driver of compliance strength, operational integrity, and member trust.

Video - Appeals & Grievances Overview
Inovaare’s industry-leading Appeals and Grievances software empowers compliance teams with end-to-end visibility of real-time data for accurate monitoring, better decision making and expedited resolutions. This explainer video walks you through what to avoid, when considering an A&G software solution, and how compliance-driven automation can help A&D Departments efficiently reach the right resolution for each member.

Inovaare Achieves HITRUST CSF® Certification
Inovaare Corporation Achieves HITRUST CSF® Certification to Manage Risk, Improve Security Posture and Meet Compliance Requirements

CMS Universe Management - Case Study
A Fortune 500 health plan serving Medicare and Medicare-Medicaid (MMP) members was looking for a management solution to create, review and submit compliant CMS universes, reduce CMS Program Audit preparation time, cut mock audit costs, demonstrate to the CMS an ability to continuously monitor their, universe tables, as well as those of their FDRs.

Brochure: Company Overview
As an industry leader of health plan solutions that drive digital transformation in healthcare, Inovaare automates complex Medicare, Medicaid and Commercial appeals and grievances (A&G) and Compliance Program Effectiveness (CPE) workflows. Its configurable cloud-based modules compile real-time data across internal and external departments, creating one compliance management system. The HIPAA-compliant platform integrates the most current, best-practice regulatory processes to help health plans efficiently meet their unique business requirements, sustain audit readiness, reduce non-compliance risks and lower overall operating costs.