Care Setting Solutions

Care setting-specific application features, custom forms, curated provider networks, and insights to enable access across the continuum of care.

Acute Cloud: Increase speed to acute care by easily and efficiently accepting patients from the ED, scheduled procedures, and other facilities outside the health system.

Post-Acute Cloud: Tools and vetted, trained providers help quickly identify and coordinate the best Post-Acute placement options, so case managers can focus on patients.

Behavioral Health Cloud: Connect patients with the care and services they need through online requests, coordination, and placement among a curated network of providers.

Curated Provider Networks

ABOUT offers Curated Provider Networks, meaning verified, trained, and maintained nationwide post-acute and behavioral health providers to augment client’s existing networks and facilitate timely coordination of patient transitions out of the acute care setting. 

Free and exceptional experience for post-acute and behavioral health providers: Drive faster and higher acceptance rates with free response application and training for providers. Competitors simply ask post-acute providers to sign up for their networks online to receive referrals. ​ 

Extensive, nationwide post-acute curated network: Over 57,000 post-acute and behavioral health providers. Unlike competitive post-acute referral networks, ABOUT identifies, secures, and onboards post-acute and behavioral health providers to ensure quick response times and optimal placement.​

Bed Visibility

Bed Visibility provides an at-a-glance view of staffed beds across the entire system and levels of care in real time to quickly identify an appropriate and available bed. 

View staffed bed availability across the health system by level of care, unit type, and facility as well as average wait times, ED pre-admits, and pending arrivals and discharges. 

Eliminate phone calls and phone tag by quickly identifying open beds and the right level of care without the need to sign into a bed management system.  

Secure Messaging

Secure Messaging seamlessly integrated in the Orchestration Engine empowers care teams to efficiently communicate and collaborate to quickly transfer patients for improved outcomes.

Increase Productivity and Accelerate Transfer Times: Eliminate excess phone calls/tag, documentation, and transcription with text messaging, pre-built templates, and pre-populated data integrated in the acute transfer workflow.

Improve Accuracy and Documentation:

Instead of relaying critical patient data via phone and transcription, secure, encrypted messaging is seamlessly integrated within case records.

Increase Care Team Satisfaction: Empower care teams to efficiently communicate on their preferred channels at their preferred times to reduce cognitive load, stress, and workload.

Intelligent Transport

Intelligent emergent and non-emergent transport coordination with real-time tracking and geo-fencing so you know exactly where the patient is in their journey to or from the care setting and have the insights and reporting to improve the process. 

Specify transport type, trip options, and specialized care or equipment needed as well as pick-up and destination locations and times to eliminate phone calls. 

Shave 15-20 minutes per patient by electronically coordinating transportation. Access data to see who gives you the best service, picks up on time, and more.

Online Transfer Request

Online Transfer Request allows internal clinicians to request transfers and notify agents online to eliminate phone calls and decrease patient transfer times. 

Enable quick and easy transfer requests, reduce data entry time and increase accuracy, accelerate transfer acceptance, and drive clinician and care team satisfaction.  

On-call Scheduling

On-Call Scheduling provides centralized physician and provider scheduling and calendar data so that patient transfer delays never occur because you can’t identify or locate the on-call physician. You can’t complete a transfer without locating the right physician to accept the patient. 

Avoid unnecessary care delays for patients, increase accuracy and accelerate provider response, and acceptance rates.

Orchestration Engine

Streamlined workflows and easy-to-use interface drive efficiencies, including the ability to perform all transition tasks from one platform.

Seamless integrations with critical data sources and systems, including EHR, ADT, CC&C platforms, CAD systems, and call recording help you get more out of existing resources. 

Disparate data pulled together to deliver actionable insights and comprehensive reporting, dashboards, and analytics unlike any other solution. 

• Arizona Surge Line (Arizona Department of Health)
• Banner Health
• Emory Healthcare
• Mercy Medical Center - Des Moines
• Mt. Sinai Health System
• Northern Arizona Healthcare
• Riverside Health System (VA)
• RWJBarnabas Health
• Sutter Health
• UPMC Central Pennsylvania

Patient Claims & Billing

All-Payer Revenue Cycle Management

Keep revenue flowing with a powerful tool that helps staff focus on real-time eligibility checks, claims status tracking and simple payment posting for both government and commercial claims.

Medicare Revenue Cycle Management

Automate your Medicare billing management with specialized software that corrects complex and multi-step claims, flags receivables at risk and allows you to perform easy eligibility look-ups.

Patient Payment

Patient Payment Management is a comprehensive patient payment software that enables you to capture more revenue and improve patient satisfaction.

Revenue Cycle Management Analytics

Improve first-pass yield on all claims. Inovalon All-Payer RCM Intelligence delivers analytic dashboards to identify performance trends, enabling decision makers to easily discover, predict, visualize, model, and manage data all in one application.

All-Payer Claims Management

Our easy-to-use electronic claims management application allows users to submit, edit and receive claims for Medicare, Medicaid and thousands of commercial insurance companies – all in one place.

Patient Statements

Inovalon Patient Statement Management software provides your patients easy-to-read breakdowns of outstanding balances, with statements white labeled to your organization.

Medicare ADR Submission

Simplify your process of secure submission, tracking, and reporting for Medicare claim review programs. This specialized software features connectivity to multiple Medicare esMD programs including ADR, RAC Audits, first- and second-level appeals, PERM, CERT, and more.

Medicare Claims Management

Medicare File Submission is a secure claims submission and remittance advice solution, giving you fast, automated processing and payment of Medicare claims.

Patient Access

Patient Registration

Reduce downstream denials and reimbursement delays through accurate patient data collection at intake. Empower staff to validate patient identity, verify eligibility, and identify all available insurance coverage, all within a few steps powered by a single patient registration software application.

Healthcare Insurance Coverage Discovery

Insurance Discovery reduces uncompensated care and underpayments by identifying active billable coverage previously unknown to the provider. Using sophisticated search capabilities, this solution identifies if patients have multiple active payers to help boost reimbursement opportunities.

All-Payer Health Insurance Eligibility Verification

Eligibility Workflow streamlines patient access and billing workflows by enabling staff to assign and prioritize patients, payers, and tasks during eligibility verification. This technology goes beyond basic eligibility needs, providing a dashboard to confirm, manage, and store every inquiry.

Healthcare Propensity to Pay

Realize the power of patient identity verification combined with custom propensity to pay scoring in one easy-to-use, cloud-based healthcare application. Lower the risk of uncompensated care and collect more revenue with more patient data readily available to make better-informed billing decisions.

Medicare Eligibility Verification

Get fast, detailed eligibility status and medical benefit information, without the hassle of juggling multiple login IDs and passwords. Eligibility Verification Medicare software enables you to submit inquiries 24/7 and receive real-time responses.

Medicare DDE/FISS Connectivity

Direct Data Exchange Verification delivers secure, online connections for Part A and Part B providers. If you need connectivity to DDE through the Professional Provider Telecommunication Network (PPTN), Regional Home Health and Hospice Intermediary (RHHI), or Claim Status Inquiry (CSI), we have you covered.

Patient Engagement

Telehealth

Inovalon’s Virtual Care software is user-friendly, reliable, and built by a team of healthcare experts with the full patient journey in mind. The solution easily integrates with eligibility, claims, and patient payment tools powered by the Inovalon ONE Platform, so you can bring key care delivery functions into one place.

• Chocta Nation Health Care Center (OK)
• Guardian Angels Senior Services
• Marshall Medical Center (CA) 
• Phelps Memorial Health Center
• Quality Care ER (TX)