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Highlights

Driving Compliance Through a Next-Generation Universe Management System

182,889

in annual operational savings

196,801

errors identified

99%

A&G Leadership/IT monthly hours savedreduction in error detection turnaround

50%

reduction in efforts for file aggregation and consolidation time

The Situation

One of the largest non-profit health care systems, headquartered in Arizona, wanted to transform their regulatory reporting processes to:

  • Increase data accuracy
  • Achieve quicker turnaround
  • Ensure seamless data aggregation

Inovaare’s Appeals and Grievances Platform is a decade ahead of their competitors. Their expertise in compliance is unparalleled and we felt they actually knew more about compliance than we did, which means we have a trusted compliance partner, not just a tech vendor

Director of Appeals and Grievances

The Challenge

The health plan faced three distinct challenges related to modernizing their regulatory reporting system:

  • Manual error identification process leading to higher turnaround time
  • Complex data aggregation process for reporting across distributed sources
  • Non-standard data collection process from other functional teams, further delaying report submission

The Solution

The health plan wanted to implement an industry-leading regulatory reporting solution quickly, so they chose Inovaare’s Universe Management System. This cloud-based regulatory compliance solution enables efficient, accurate and proper formatting of CMS universes. The benefits include:

  • Automated processing of universe documents in just a few clicks
  • Extraction and categorization of errors for quicker resolution
  • Central framework to consolidate files across different sources for faster audit preparedness
  • Comprehensive reporting to improve transparency through the enterprise

The Impact

After going live with Inovaare’s Universe Management System, the health plan was able to:

  • Enable seamless CMS universe monitoring and reporting for improved audit readiness
  • Deliver a superior user experience through accelerated response turnaround times
  • Empower teams to quickly aggregate universes from multiple sources
  • Identify compliance risks for proactive management and quicker resolution of issues
  • Monitor future compliance issues with actionable Timeliness Dashboards
  • Improve seamless collaboration across other functional teams/ areas through streamlined and standardized data collection

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Inovaare offers a Generative AI-powered compliance operating platform, industry-leading solutions and consulting services that enable healthcare payers and providers to transform business operations with improved accuracy and efficiency with a low cost of ownership.

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