JSON twin: https://www.healthaidb.com/software/inovalon-claims-management-pro.json
Inovalon
Cloud-based claims management and revenue cycle automation platform that submits, scrubs, tracks, and reports on claims across Medicare, Medicaid and commercial payers to improve clean-claim rates and reduce days in A/R.
SaaS claims management solution for provider revenue cycle teams offering pre‑filing eligibility checks, advanced claims scrubbing with customizable rules, single‑portal all‑payer submission/tracking, automated secondary filings, task routing/alerts, and predictive analytics/reporting to optimize cash collection and reduce rework.
yes
1998
US-based cloud hosting (regional options via Inovalon platform; details per contract)
P0799
2025-09-07
proprietary commercial
Contact vendor for pricing, tiers, and trial/demo information.
enterprise_quote
product
1.0
{
"company_name": "Inovalon",
"company_url": "https://www.inovalon.com/",
"company_offices": [
"United States",
"India"
],
"company_founding": "1998",
"product_url": "https://www.inovalon.com/products/provider-cloud/revenue-cycle-management/all-payer-revenue-cycle-management/",
"categories": [
"administrative",
"revenue cycle management",
"claims management",
"provider-facing",
"cloud SaaS"
],
"market_segment": [
"enterprise",
"providers"
],
"links": [
"https://www.inovalon.com/products/provider-cloud/revenue-cycle-management/all-payer-revenue-cycle-management/",
"https://www.inovalon.com/lp/claims-management/",
"https://www.inovalon.com/wp-content/uploads/2024/02/PRO-24-0312-Claims-Management-Pro-Product-Sheet-Rebrand.pdf",
"https://www.inovalon.com/wp-content/uploads/2023/06/INOV-Claims-Management-Pro-Product-Documentation-leave-behind-6.16.23-v1.0.0.pdf",
"https://elion.health/products/inovalon-claims-management-pro",
"https://www.g2.com/products/inovalon-claims-management-pro/reviews",
"https://klasresearch.com/review/inovalon-claims-management-pro/343145",
"https://www.inovalon.com/products/provider-cloud/",
"https://support.inovalon.com/",
"https://www.inovalon.com/about/"
],
"summary": "Cloud-based claims management and revenue cycle automation platform that submits, scrubs, tracks, and reports on claims across Medicare, Medicaid and commercial payers to improve clean-claim rates and reduce days in A/R.",
"description": "SaaS claims management solution for provider revenue cycle teams offering pre‑filing eligibility checks, advanced claims scrubbing with customizable rules, single‑portal all‑payer submission/tracking, automated secondary filings, task routing/alerts, and predictive analytics/reporting to optimize cash collection and reduce rework.",
"target_users": [
"billers",
"revenue cycle managers",
"billing services",
"provider financial admins",
"RCM teams",
"post-acute providers",
"home health agencies",
"hospice agencies",
"skilled nursing facilities",
"health system revenue cycle staff"
],
"specialties": [
"revenue cycle management",
"medical billing",
"home health",
"hospice",
"skilled nursing/post-acute",
"ambulatory care",
"hospital/health system"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "enterprise_quote",
"pricing_details": "Contact vendor for pricing, tiers, and trial/demo information.",
"license": "proprietary commercial",
"deployment_model": [
"SaaS"
],
"os_platforms": [
"Web"
],
"features": [
"Claims scrubbing with rules engine for CMS and commercial payer rules",
"Eligibility verification across payers during claim upload",
"Claims status tracking and dashboards",
"Automated workflows for audit responses and appeals",
"ADR tracking and appeal submissions",
"Automated secondary claim submissions",
"ERA access and remittance download",
"Work queue routing with correction guidance",
"Configurable staff/workflow assignment",
"Denial management and analytics",
"First-pass payer acceptance optimization"
],
"optional_modules": [
"Claims Management Medicare Pro",
"Claims Management Starter",
"RCM Intelligence (analytics)"
],
"integrations": [
"Payers (Medicare, Medicaid, commercial payers)",
"Clearinghouses",
"Electronic Remittance Advice (ERA) systems",
"Billing systems / practice management",
"EHRs / clinical systems (generic integration points)"
],
"data_standards": [
"X12 (837/835/270/271)",
"HL7",
"FHIR"
],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"HIPAA"
],
"certifications": [],
"security_features": [
"Encryption (in transit and at rest)",
"Role-based access control (RBAC)",
"Single sign-on / SAML",
"Audit logging",
"Multi-factor authentication (MFA/2FA)"
],
"privacy_features": [
"Business Associate Agreement (BAA) available",
"Access controls",
"Audit trails"
],
"data_residency": "US-based cloud hosting (regional options via Inovalon platform; details per contract)",
"customers": [],
"user_reviews": [],
"ratings": [
"G2 — 4.4/5 (Inovalon Claims Management Pro listing)"
],
"support_channels": [
"email",
"phone",
"chat",
"ticketing"
],
"training_options": [
"documentation",
"webinars",
"live_online",
"onsite",
"certification"
],
"release_year": "",
"integration_partners": [
"Amazon Web Services (AWS)",
"Amazon Comprehend Medical",
"CommonWell Health Alliance",
"HealthVerity",
"Brightree",
"Surescripts",
"Inovalon Clearinghouse"
],
"id": "P0799",
"slug": "inovalon-claims-management-pro",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/inovalon-claims-management-pro.json"
}
}