info@inovaare.com 1.408.850.2235
Dome Tech Engineering

A collaborative product that automates member appeal process, enforces compliance and generates various management, operational, compliance and quality related dashboard and reports.

Appeal Case Management

The CASE Manager automates pre and post service appeal processes including issue intake, issue investigation, decision making and appeal closure.

appealcasemgmt
generatedletter

Letter Generation

The letter generation features provides a comprehensive letter generation and tracking process to ensure appropriate and timely member correspondence.

Reports and Dashboards

Pre-built dashboards, reports and trend analysis for various regulatory and quality oversight entities including CMS and NCQA.

AngPortal
appealcasemgmt

External Appeal

Tracking and monitoring of external appeal process including IRE, ALJ, MAC and Judicial Review.

Features

  • Pre-built A&G metadata

    • Configurable as per customer need

  • Comprehensive workflow

    • Case intake

    • Review and case investigation

    • Decision and case closure

    • External review processing

    • Configurable as per customer need

  • Member correspondence

    • Pre-built CMS letter templates

    • Automatic letter generation

    • Member & provider correspondence

  • Reports and Dashboards

    • Operational reports

    • Management dashboards

    • Trend analysis

    • Turn-around time reporting

    • Pre-built compliance report

    • Pre-built NCQA & CMS reports

  • IPA oversight

    • Trend analysis by IPA

  • Rules, alerts and notifications

    • Built-in compliance rules for standard, expedite and other type of cases

    • Configurable alert and notifications

 

Benefit

Inovaare’s Appeal system will assist you in monitoring, auditing, and overseeing your organization’s appeal operations, with the aim of achieving better performance outcomes and ultimately enhancing service delivery and ensuring better coverage for beneficiaries.

 

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