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Transform Compliance & Operations with AI-Powered Healthcare Payer Solutions

Your health cloud platform to automate compliance oversight, streamline operations management, improve member experience and lower costs with advanced healthcare payer solutions.

Healthcare Payer Solution dashboard

Healthcare Native. Payer Approved.

A legacy of trust in driving payer operations

Years of enabling healthcare excellence
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Health plans rely on our technology solutions
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Members
impacted
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Blue Members
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User base
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What we solve for

What’s slowing down healthcare payers?

Ever-changing compliance regulations, data silos, and manual workflows create inefficiencies for your health plan. Our AI-powered A&G, Risk Management, and Regulatory Compliance solutions help health plans resolve these challenges with smart healthcare payer software for compliance automation.

Regulatory compliance risk Regulatory compliance risk

Staying compliant with regulations is time-consuming and error-prone and non-compliance could lead to penalties and audit failures.

Siloed, inaccessible data Siloed, inaccessible data

Legacy systems don’t communicate, making it hard to get a unified, real-time view of compliance and operational metrics.

Manual processes & inefficiencies Manual processes & inefficiencies

High-touch processes like appeals, grievances, and risk management slow teams down, increasing costs and delaying issue resolution.

Member experience challenges Member experience challenges

Slow responses and disconnected systems frustrate members, impacting member satisfaction, Star Ratings and retention.

Decoding compliance & operations

How we transform compliance &
operations for health plans

Our health cloud platform combines AI automation, real-time compliance tracking, and seamless workflows to cut costs,
reduce risk, and improve payer performance.

Inovaare-AI-driven

Compliance automation

Automates compliance with built-in rules, real-time tracking, and audit-ready workflows, improving efficiencies and reducing risk.

Inovaare-Unified-API-first-platform

Unified API-first platform

Eliminates data silos by connecting disparate systems and delivering unified compliance insights and analytics.

Inovaare-Compliance-first-approach

Compliance-first approach

Ensures every workflow, update, and integration continuously align with the ever-changing regulatory requirements.

Inovaare-Member-first focus

Member-first focus

Helps health plans deliver faster resolutions and creates better experiences, all while supporting compliance and reducing cost.

Explore our products Built for Healthcare Payers

Purpose-built solutions for smarter, faster healthcare operations

Transform compliance and operations with targetted SaaS solutions built on a secure, scalable, and BOAT-powered Health Cloud platform. Customize effortlessly as your business grows.

Inovaare-member-experience

Appeals & Grievances Management

Inovaare-audit-and-monitoring

Audit &
Monitoring

Inovaare-healthcare-data-scrubbers

Universe Management System

Inovaare-Provider-Relationship-Management

Member Experience Platform

Inovaare-Delegation-Oversight

Delegation
Oversight

integrated artificial intelligence

The future of healthcare operations is agentic

We’re redefining healthcare operations with task-specific AI agents built on Usher AI. These agents automate repetitive, error-prone tasks—improving compliance, reducing cost, and accelerating workflows.
The result? Faster workflows. Smarter decisions. Lower cost.

Regulatory agent

Monitors, categorizes, and summarizes regulatory updates in real time to keep your team audit-ready.

Inovaare-Case-intake-agent

Case intake agent

Captures, validates, and routes Appeals & Grievances cases to reduce errors and speed up resolution.

Inovaare-Audit-notice-agent

Audit notice agent

Reads notices, flags deadlines, and assigns tasks automatically to support timely responses, every time.

Data collection agent

Automates surveys and data gathering for payer data insights, fast analysis, and better decision making.

A platform you can trust

Secure. Compliant. Effortless.

Healthcare Solutions

HITRUST-certified

We protect your data with enterprise-grade security, encryption, and 24/7 monitoring.

Healthcare Solutions

HIPAA compliant

Built-in compliance features ensure smooth alignment with CMS, Medicare, and Medicaid.

Inovaare-scalable

Scalable architecture

Cloud-native, API-first, and auto-scaling for seamless growth and adaptability.

Gartner

Transformational Recognition in Healthcare Technology

Inovaare Recognized in Gartner® Hype Cycle™ for Healthcare Payers

We’ve been recognized as a Sample Vendor in Gartner® “Hype Cycle for U.S. Healthcare Payers, 2024” report, specifically for its innovative solutions in the categories of LLMs for Healthcare Payers and Consumer-Centric Health Products. Gartner® in it’s report “AI Reshapes How U.S. Healthcare Payer CIOs Do Business,” predicts that by 2027, GenAI solutions will reduce administrative cost by 30% for most health insurers with more than one million members.

Disclaimers:
Gartner, Predicts 2025: AI Reshapes How U.S. Healthcare Payer CIOs Do Business, 16 January 2025, Faith Adams, Austynn Evansbank, Connie Salgy

Gartner, Hype Cycle for U.S. Healthcare Payers, 2024, 28 July 2024, Mandi Bishop, Austynn Evansbank, Connie Salgy GARTNER is a registered trademark and service mark, and Hype Cycle is a registered trademark of Gartner, Inc. and/or its affiliates in the U.S. and internationally and are used herein with permission. All rights reserved.

Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

Hear from our customers

Our Value

Delivering measurable outcomes

We transform your healthcare operations, helping you save hours on audit-related documentation and reporting. Achieve significant compliance-related cost savings and ensure timely, accurate regulatory submissions. 

Blue members served
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Lesser audit review time
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Lower follow-up cost
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First-pass submissions
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Resources

FAQs

Have questions? We have answers.

Regulatory Compliance

How does Inovaare help with CMS, Medicare, and Medicaid compliance?

Inovaare’s platform automates compliance tracking, ensures real-time regulatory updates, and provides audit-ready universes to keep health plans aligned with CMS, Medicare, and Medicaid regulations. With built-in rule-based automation, you can reduce compliance risks and improve audit outcomes effortlessly.

What happens in case of regulatory changes?

Our AI-powered platform adapts in real time to regulatory updates. Inovaare integrates compliance rule updates automatically, ensuring that your organization remains compliant without IT intervention. Stay ahead of policy shifts with proactive monitoring and automated workflows.

Pricing & Implementation

How long does implementation take?

Implementation time varies based on the complexity of your operations, but most health plans can go live with Inovaare’s core solutions in under 90 days. Our modular, cloud-native architecture ensures a phased rollout that aligns with your business needs.

What kind of support does Inovaare provide?

We offer 24/7 customer support, dedicated compliance consultants, and personalized training sessions to ensure seamless adoption. Our support team helps with onboarding, system optimization, and ongoing compliance updates to maximize your ROI.

Operations

How does Inovaare help in improving operational efficiency?

By eliminating manual processes, reducing IT dependencies, and automating Appeals & Grievances (A&G), audits, and compliance tracking, Inovaare improves workflow efficiency across payer operations. AI-driven insights enhance decision-making, while self-service configuration allows for quick adaptability.

Can Inovaare reduce audit review and preparation time and costs?

Yes. Inovaare’s automated scrubbing, pre-configured compliance checks, and real-time monitoring reduce audit preparation time by up to 90%. Health plans that implement Inovaare see a significant reduction in review time and external audit costs, leading to faster issue resolution and improved compliance performance.

Technology

How does Inovaare integrate with our existing systems?

Inovaare is API-first and built for interoperability, allowing seamless integration with EHRs, claims management systems, CRMs, and regulatory reporting tools. Our platform eliminates data silos, ensuring unified, real-time access to compliance and operational insights.

How does Inovaare handle large data volumes and high transaction loads?

Our scalable cloud infrastructure supports multi-region deployments and auto-scaling, ensuring fast processing of high transaction volumes without performance degradation. Optimized data pipelines allow for real-time analytics and reporting, even with massive datasets.

Explore our AI-driven healthcare solutions

Struggling with compliance burdens, operational delays, or data gaps?

Discover how Inovaare’s SaaS-based payer solutions, built on its AI-powered platform,
help health plans streamline processes, reduce risk, and improve member outcomes.

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