Claims Management Pro

JSON twin: https://www.healthaidb.com/software/claims-management-pro.json

Company Name

Inovalon

Product URL

https://www.inovalon.com/products/claims-management-pro

Company URL

https://www.inovalon.com

Categories

• administrative Operations
• revenue Cycle
• healthcare It
• software As A Service
• Administrative
• Revenue Cycle Management
• Claims Management
• Saas

Summary

Inovalon's Claims Management Pro is a cloud-based software solution that automates and streamlines the healthcare claims process, enhancing efficiency and accuracy for providers.

Description

Claims Management Pro offers features such as automated claims submission, real-time eligibility verification, and advanced analytics to improve revenue cycle management. It integrates seamlessly with existing systems, including Electronic Health Records (EHRs), and is available as a Software as a Service (SaaS) solution. The platform is designed to reduce claim denials and accelerate reimbursements, achieving a 99% first-pass acceptance rate among commercial and Medicare payers. It also provides a single sign-on experience for users, integrating with platforms like PointClickCare. Additionally, the solution offers automated workflows for claims resolution and integrates with clearinghouses to facilitate electronic submissions. Claims Management Pro is available on the PointClickCare Marketplace, offering a unified user experience for healthcare providers. The platform is designed to reduce claim denials and accelerate reimbursements, achieving a 99% first-pass acceptance rate among commercial and Medicare payers. It also provides a single sign-on experience for users, integrating with platforms like PointClickCare. Additionally, the solution offers automated workflows for claims resolution and integrates with clearinghouses to facilitate electronic submissions. Claims Management Pro is available on the PointClickCare Marketplace, offering a unified user experience for healthcare providers. ([globenewswire.com](https://www.globenewswire.com/news-release/2023/10/16/2760696/0/en/Inovalon-s-Claims-Management-Pro-Is-Now-Available-on-the-PointClickCare-Marketplace.html?utm_source=openai))

Api Available

unknown

Certifications

• FDA 510(k)
• CE/MDR
• ONC
• ISO

Company Founding

1998

Company Offices

• United States
• Canada
• United Kingdom
• Australia
• Germany
• France
• Italy
• Spain
• Netherlands
• Sweden

Compliance

• HIPAA
• GDPR
• HITECH
• SOC 2
• ISO 27001

Customers

• Trinity Health
• Silna Health
• Kayla B.
• Leigh Ann C.
• Lauren G.

Data Residency

US/EU regions

Data Standards

• FHIR
• HL7 v2
• DICOM
• SNOMED
• ICD-10

Deployment Model

• SaaS

Features

• Automated claims correction tools
• Integrated eligibility verification
• Advanced rules engine
• Automated claims correction tools and work assignments
• Medicare claim status and detail visibility
• Real-time revenue insights
• Performance management analytics
• Advanced visualization into denial-causing categories
• All-payer claims management dashboard
• 99% or better clean claims rate
• Eligibility verification during claims upload

Id

SW1553

Integration Partners

• Clearinghouse Integration
• Claims Data Automation
• Claims Process Workflow
• Claims Resubmission
• Patient Data Security
• Claims Scrubbing

Integrations

• KanTime
• MEDITECH
• Homecare Homebase
• iCANotes

Languages Supported

• English
• Spanish
• French
• German
• Italian
• Dutch
• Swedish
• Norwegian
• Danish
• Finnish
• Belgian Dutch
• Swiss German
• Austrian German
• Irish English
• New Zealand English
• Japanese
• Korean
• Chinese
• Portuguese
• Russian

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

• Claims Management Medicare Pro
• Patient Payment Management
• Patient Statement Management
• Direct Data Entry Verification
• Insurance Discovery
• RCM Intelligence
• Eligibility Workflow
• Claims Management Starter
• Claims Management Pro
• Claims Management

Os Platforms

• Web

Pricing Details

Contact vendor for pricing information.

Pricing Model

subscription

Privacy Features

• BAA available
• consent mgmt
• anonymization
• data minimization

Product Code

SW1553

Product Name

Claims Management Pro

Ratings

• 4.4 out of 5 stars on G2
• 4.9 out of 5 stars on G2 for Silna Health
• 4.5 out of 5 stars on G2 for Beaulah S.

Regions Available

• United States
• Canada
• United Kingdom
• Australia
• Germany
• France
• Italy
• Spain
• Netherlands
• Sweden
• Norway
• Denmark
• Finland
• Belgium
• Switzerland
• Austria
• Ireland
• New Zealand
• Japan
• South Korea

Related Urls

• https://elion.health/products/inovalon-claims-management-pro

Release Year

2015

Security Features

• Encryption
• RBAC
• SSO/SAML
• audit logs
• 2FA
• DLP

Specialties

• General Healthcare
• Hospital Systems
• Ambulatory Practices
• Skilled Nursing Facilities
• Long-term Care Facilities
• Home Health Agencies
• Rehabilitation Centers
• Hospices
• Palliative Care
• Primary Care
• Specialty Care
• Urgent Care
• Emergency Care
• Outpatient Services
• Inpatient Services
• Mental Health Services
• Substance Abuse Treatment
• Pediatrics
• Geriatrics
• Women's Health

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• clinicians
• nurses
• admins
• healthcare providers

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• Very easy to navigate, research and accomplish your task at hand thoroughly.
• I do like how organized the claims are kept. They are also sent in a timely manner, and we can get errors we need to fix before the claim is processed by insurance.
• I like that it highlights the last line that was reviewed, that makes it much easier to find the last person I was on when correcting/reviewing claims.

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Claims Management Pro",
  "company_name": "Inovalon",
  "product_url": "https://www.inovalon.com/products/claims-management-pro",
  "company_url": "https://www.inovalon.com",
  "related_urls": [
    "https://elion.health/products/inovalon-claims-management-pro"
  ],
  "product_code": "SW1553",
  "summary": "Inovalon's Claims Management Pro is a cloud-based software solution that automates and streamlines the healthcare claims process, enhancing efficiency and accuracy for providers.",
  "description": "Claims Management Pro offers features such as automated claims submission, real-time eligibility verification, and advanced analytics to improve revenue cycle management. It integrates seamlessly with existing systems, including Electronic Health Records (EHRs), and is available as a Software as a Service (SaaS) solution. The platform is designed to reduce claim denials and accelerate reimbursements, achieving a 99% first-pass acceptance rate among commercial and Medicare payers. It also provides a single sign-on experience for users, integrating with platforms like PointClickCare. Additionally, the solution offers automated workflows for claims resolution and integrates with clearinghouses to facilitate electronic submissions. Claims Management Pro is available on the PointClickCare Marketplace, offering a unified user experience for healthcare providers. The platform is designed to reduce claim denials and accelerate reimbursements, achieving a 99% first-pass acceptance rate among commercial and Medicare payers. It also provides a single sign-on experience for users, integrating with platforms like PointClickCare. Additionally, the solution offers automated workflows for claims resolution and integrates with clearinghouses to facilitate electronic submissions. Claims Management Pro is available on the PointClickCare Marketplace, offering a unified user experience for healthcare providers. ([globenewswire.com](https://www.globenewswire.com/news-release/2023/10/16/2760696/0/en/Inovalon-s-Claims-Management-Pro-Is-Now-Available-on-the-PointClickCare-Marketplace.html?utm_source=openai))",
  "categories": [
    "administrative Operations",
    "revenue Cycle",
    "healthcare It",
    "software As A Service",
    "Administrative",
    "Revenue Cycle Management",
    "Claims Management",
    "Healthcare It",
    "Saas"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "clinicians",
    "nurses",
    "admins",
    "healthcare providers"
  ],
  "specialties": [
    "General Healthcare",
    "Hospital Systems",
    "Ambulatory Practices",
    "Skilled Nursing Facilities",
    "Long-term Care Facilities",
    "Home Health Agencies",
    "Rehabilitation Centers",
    "Hospices",
    "Palliative Care",
    "Primary Care",
    "Specialty Care",
    "Urgent Care",
    "Emergency Care",
    "Outpatient Services",
    "Inpatient Services",
    "Mental Health Services",
    "Substance Abuse Treatment",
    "Pediatrics",
    "Geriatrics",
    "Women's Health"
  ],
  "regions_available": [
    "United States",
    "Canada",
    "United Kingdom",
    "Australia",
    "Germany",
    "France",
    "Italy",
    "Spain",
    "Netherlands",
    "Sweden",
    "Norway",
    "Denmark",
    "Finland",
    "Belgium",
    "Switzerland",
    "Austria",
    "Ireland",
    "New Zealand",
    "Japan",
    "South Korea"
  ],
  "languages_supported": [
    "English",
    "Spanish",
    "French",
    "German",
    "Italian",
    "Dutch",
    "Swedish",
    "Norwegian",
    "Danish",
    "Finnish",
    "Belgian Dutch",
    "Swiss German",
    "Austrian German",
    "Irish English",
    "New Zealand English",
    "Japanese",
    "Korean",
    "Chinese",
    "Portuguese",
    "Russian"
  ],
  "pricing_model": "subscription",
  "pricing_details": "Contact vendor for pricing information.",
  "license": "commercial",
  "company_offices": [
    "United States",
    "Canada",
    "United Kingdom",
    "Australia",
    "Germany",
    "France",
    "Italy",
    "Spain",
    "Netherlands",
    "Sweden"
  ],
  "company_founding": "1998",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Automated claims correction tools",
    "Integrated eligibility verification",
    "Advanced rules engine",
    "Automated claims correction tools and work assignments",
    "Medicare claim status and detail visibility",
    "Real-time revenue insights",
    "Performance management analytics",
    "Advanced visualization into denial-causing categories",
    "All-payer claims management dashboard",
    "99% or better clean claims rate",
    "Eligibility verification during claims upload"
  ],
  "optional_modules": [
    "Claims Management Medicare Pro",
    "Patient Payment Management",
    "Patient Statement Management",
    "Direct Data Entry Verification",
    "Insurance Discovery",
    "RCM Intelligence",
    "Eligibility Workflow",
    "Claims Management Starter",
    "Claims Management Pro",
    "Claims Management"
  ],
  "integrations": [
    "KanTime",
    "MEDITECH",
    "Homecare Homebase",
    "iCANotes"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "DICOM",
    "SNOMED",
    "ICD-10"
  ],
  "api_available": "unknown",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "GDPR",
    "HITECH",
    "SOC 2",
    "ISO 27001"
  ],
  "certifications": [
    "FDA 510(k)",
    "CE/MDR",
    "ONC",
    "ISO"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "audit logs",
    "2FA",
    "DLP"
  ],
  "privacy_features": [
    "BAA available",
    "consent mgmt",
    "anonymization",
    "data minimization"
  ],
  "data_residency": "US/EU regions",
  "customers": [
    "Trinity Health",
    "Silna Health",
    "Kayla B.",
    "Leigh Ann C.",
    "Lauren G."
  ],
  "user_reviews": [
    "Very easy to navigate, research and accomplish your task at hand thoroughly.",
    "I do like how organized the claims are kept. They are also sent in a timely manner, and we can get errors we need to fix before the claim is processed by insurance.",
    "I like that it highlights the last line that was reviewed, that makes it much easier to find the last person I was on when correcting/reviewing claims."
  ],
  "ratings": [
    "4.4 out of 5 stars on G2",
    "4.9 out of 5 stars on G2 for Silna Health",
    "4.5 out of 5 stars on G2 for Beaulah S."
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2015",
  "integration_partners": [
    "Clearinghouse Integration",
    "Claims Data Automation",
    "Claims Process Workflow",
    "Claims Resubmission",
    "Patient Data Security",
    "Claims Scrubbing"
  ],
  "id": "SW1553",
  "slug": "claims-management-pro",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/claims-management-pro.json"
  }
}