Inovalon

Powering data-driven healthcare.

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Overview

Inovalon is a leading technology company providing cloud-based platforms that empower data-driven healthcare. Their solutions are used by payers, providers, and life sciences organizations. For providers, Inovalon offers a suite of revenue cycle management tools, including robust eligibility verification, claims management, and analytics, designed to improve financial performance and operational efficiency.

✨ Key Features

  • Eligibility Verification (Starter, Standard, Pro)
  • Insurance Discovery
  • Claims Management
  • Denial Management
  • Data Analytics

🎯 Key Differentiators

  • Massive, proprietary dataset connecting to a majority of US providers and pharmacies
  • Real-time data access and primary source verification
  • Broad suite of solutions covering payers, providers, and pharmacy

Unique Value: Leverages massive scale, national connectivity, and advanced analytics to provide a comprehensive platform that improves both clinical and financial outcomes for all major healthcare stakeholders.

🎯 Use Cases (3)

Automating eligibility checks for large patient volumes Discovering unknown billable coverage for self-pay patients Managing and appealing claim denials with supporting eligibility data

✅ Best For

  • Batch eligibility verification for hospitals and large practices
  • Retrieving detailed benefit information from a wide range of commercial and government payers

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Very small practices that may not need the extensive analytics and data capabilities of the platform.

🏆 Alternatives

Optum Cotiviti Health Catalyst Veradigm

Offers a broader reach into the pharmacy and life sciences sectors and more direct, real-time data connectivity compared to many other analytics vendors.

💻 Platforms

Web API

🔌 Integrations

EHR/PM Systems API

🛟 Support Options

  • ✓ Email Support
  • ✓ Phone Support
  • ✓ Dedicated Support (Varies tier)

🔒 Compliance & Security

✓ SOC 2 ✓ HIPAA ✓ BAA Available ✓ SSO ✓ SOC 1 Type 2 ✓ SOC 2 Type 2 ✓ HITRUST

💰 Pricing

Contact for pricing
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