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Inovalon Converged DUR

Empowering data-driven healthcare.

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Overview

Inovalon is a leading provider of cloud-based platforms empowering data-driven healthcare. While they offer a wide array of solutions, their capabilities include supporting payers with quality improvement and utilization management. Their platform can analyze large-scale claims and clinical data sets to identify gaps in care, medication non-adherence, and instances of potentially inappropriate therapy. This retrospective and predictive analysis is a key form of drug utilization review for health plans.

✨ Key Features

  • Large-scale data aggregation and analysis
  • Quality improvement analytics (HEDIS/Stars)
  • Risk adjustment solutions
  • Care gap identification
  • Provider performance measurement

🎯 Use Cases (3)

Analyzing claims data to identify members for MTM or other interventions. Identifying patterns of inappropriate prescribing across a provider network. Predicting members at high risk for non-adherence or adverse events.

✅ Best For

  • Use by national and regional health plans for quality reporting and risk adjustment.

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Real-time, point-of-care decision support for clinicians.

💻 Platforms

Web API

🔌 Integrations

Payer data systems EHR data feeds PBM data feeds

🛟 Support Options

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

🔒 Compliance & Security

✓ SOC 2 ✓ HIPAA ✓ BAA Available ✓ ISO 27001 ✓ SSO ✓ NCQA Certified

💰 Pricing

Contact for pricing
Visit Inovalon Converged DUR Website →