Inovalon Eligibility VerificationInovalon
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RCM EdgeISpectra Technologies Global
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About
Eligibility Verification Standard streamlines patient access and billing workflows by enabling staff to assign and prioritize patients/residents, payers, and tasks during eligibility verification. This technology goes beyond basic eligibility needs, providing a dashboard to confirm, manage, and store every inquiry. Speed up eligibility verification processes with automated enrichment of incomplete or incorrectly formatted transactions from the payer. Perform multiple eligibility inquiries at once with batch file uploads that verify Medicaid, Medicare, and commercial coverage quickly and efficiently. Easily assign tasks to team members, apply follow-up flags, and create eligibility documentation for future reference. Manage patients between batches and resolve issues with just a few clicks. Save time and ensure coverage accuracy with one cloud-based, all-payer health insurance eligibility verification software that empowers staff to manage benefit inquiries however, works best for them.
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About
RCM Edge is an AI-powered revenue cycle management platform for medical billing companies, physician practices, clinics, hospitals, and health systems. It automates billing workflows from eligibility verification to reimbursement and works with existing EHR and practice-management systems. Edge Verify performs real-time insurance eligibility and benefits checks across 566 payer connections. Edge Claims tracks claim status across 468 payer connections, normalizes payer responses, and routes unresolved claims to follow-up queues so staff can focus on exceptions. The platform uses robotic process automation (RPA), predictive analytics, and real-time intelligence to help teams reduce manual work. Prior authorization, denial management, and accounts receivable follow-up are in development, not live modules.
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Platforms Supported
Windows
Not Supported
Mac
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Linux
Not Supported
Cloud
Supported
On-Premises
Not Supported
iPhone
Not Supported
iPad
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Android
Not Supported
Chromebook
Not Supported
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Platforms Supported
Windows
Not Supported
Mac
Not Supported
Linux
Not Supported
Cloud
Supported
On-Premises
Supported
iPhone
Not Supported
iPad
Not Supported
Android
Not Supported
Chromebook
Not Supported
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Audience
Health professionals seeking a tool to streamline and accelerate coverage checks with all-payer eligibility software for better workflow and accuracy
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Audience
Medical billing companies, physician practices, clinics, hospitals, and healthcare revenue cycle management teams.
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Support
Phone Support
Supported
24/7 Live Support
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Online
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Support
Phone Support
Supported
24/7 Live Support
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Online
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API
Offers API
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API
Offers API
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Pricing
No information available.
Free Version
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Free Trial
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Pricing
$200/month
The Professional plan starts at $200 per month. A free 30-day trial is offered. Enterprise pricing is customized.
Free Version
Supported
Free Trial
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Reviews/
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Reviews/
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Training
Documentation
Supported
Webinars
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Live Online
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In Person
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Training
Documentation
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Webinars
Not Supported
Live Online
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In Person
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Company InformationInovalon
Founded: 1998
United States
www.inovalon.com/products/provider-cloud/revenue-cycle-management/all-payer-insurance-eligibility-verification/
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Company InformationISpectra Technologies Global
Founded: 2023
United States
rcmedge.ai/
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Integrations
Inovalon Provider Cloud
Not Supported
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