Inovalon Expands Revenue Cycle Data Analytics Software to Support All EDI Clearinghouses for Healthcare Providers

SaaS Solution Delivers up to 93% First-Pass Yield and Prevents Revenue Leakage While Improving Cash Flow by up to 15%

BOWIE, Md., April 19, 2023 (GLOBE NEWSWIRE) — Inovalon, a leading provider of cloud-based software solutions empowering data-driven healthcare, today announced that RCM Intelligence, a revenue cycle management (RCM) solution providing integrated analytics and data visualization capabilities, will now be compatible with all electronic data interchange (EDI) claims clearinghouses, connecting to commercial, Medicare, and Medicaid payers. Leveraging Inovalon’s advanced analytics, RCM Intelligence seamlessly operationalizes raw claims data to deliver real-time insights that improve cash flow, profitability, and productivity for healthcare providers without having to compromise performance based on which EDI clearinghouses they may be using. These insights include payer performance trends, claims corrections, cash projections, time-to-file rates, turnaround times, and denial percentages.

Traditional RCM reporting is labor-intensive, inefficient, and generally manual, increasing the likelihood of errors and denials from health plans. Initial claim denials can occur up to 20% of the time and cost up to $118 per claim to rework, contributing to financial pressure on providers and delaying the availability of reimbursements. Providers often lack visibility into the root causes of these errors, thus impeding their efforts to improve the overall health of financial operations.

“RCM Intelligence provides insight that my EHR can’t. It’s easy to use and has proven especially valuable in achieving a very strong first-pass yield rate,” said Patricia Bemis, Director of Revenue Cycle at Brattleboro Retreat, a not-for-profit psychiatric and addiction treatment hospital. “I love that denials are categorized to identify problematic departmental workflows and that I can easily see what’s being worked on, where additional training might be needed, and how various team members perform.”

RCM Intelligence saves valuable time and resources by eliminating the need for manual reporting and automating the delivery of actionable information such as associate productivity and high-impact tasks that can translate to cost savings. In addition, RCM Intelligence can identify which payers are reimbursing the slowest, where claims delays are occurring, and which denials have the highest claim value for prioritization. The result is higher first-pass yields of up to 93%, fewer days in accounts receivable aging, 40% fewer avoidable denials, less revenue leakage, and increased cash flow by up to 15%.

“Inovalon has decades of experience in billing and processing healthcare claims, which we have leveraged for the purposeful development, and now expansion, of a truly transformative RCM software solution,” said Eron Kelly, President of Inovalon. “Now that RCM Intelligence is clearinghouse-agnostic, we can empower even more providers to turn insights into action and help them identify solutions, rather than problems, to maximize their ability to focus on delivering great care while our solutions support their productivity and economic efficiency too.”

RCM Intelligence remains fully interoperable with Inovalon’s EASE All-Payer as part of the provider suite of solutions powered by the Inovalon ONE^® Platform.

For more information on RCM Intelligence, please visit https://www.inovalon.com/lp/rcm-intelligence/ or booth #2244 at the 2023 HIMSS Conference in Chicago between April 17-21.

About Inovalon

Inovalon is a leading provider of cloud-based solutions empowering data-driven healthcare. The Inovalon ONE^® Platform, which consists of more than 100 cloud-based solutions, delivers national-scale connectivity for real-time aggregation and analysis of data to drive improved patient outcomes, efficiency, and financial performance across the healthcare ecosystem. The company’s analytics and capabilities are used by more than 20,000 customers and are informed by data from more than one million physicians, 72 billion medical events across 627,000 clinical settings and 361 million unique patients. For more information, visit www.inovalon.com/.

Contact:

Whitney Swistock
Sr. Manager, Communications, Inovalon
Whitney.Swistock@inovalon.com