Inovaare Revolutionizes the CMS Audit Program Preparation Process


“Inovaare knows the world of Medicare and Medicaid health plans from decades of hands-on Regulatory Compliance department leadership and oversight, which is how we created this turnkey CMS universe validation solution with audit protocol changes included.”

Inovaare Corporation, a healthcare compliance and operations management software provider leading digital transformation within the industry, today announced the launch of its Universe Management Suite, a Centers for Medicare & Medicaid (CMS) universe data-validation and regulatory report solution that can be implemented within weeks. Guided by a team with over 125 years of combined regulatory compliance experience, the Universe Management Suite was developed in partnership with several health plans who have been successfully using it for mock audits and program audits.

The Universe Management Suite is comprised of three modules — Universe Scrubber, Universe Generator and Universe Aggregator — and helps health plans to simplify complex audit-preparation processes, ensure properly formatted CMS universe tables and expedite report submissions. Compliance personnel can easily upload universe tables into Universe Scrubber, which identifies issues with turnaround times, outliers and inclusion/exclusions criteria within minutes later. Universe Generator reduces the risk of penalties and low star ratings, while increasing report turnaround times, by allowing compliance teams to fulfill their own data or query results and create properly formatted CMS universes with the click of a button. Completing the Universe Management Suite, Universe Aggregator compiles universe data into a single table, even when the same universes are submitted by multiple personnel.

“Inovaare’s cloud-based data platform enables health plans to meet constantly evolving business and regulatory requirements while providing a seamless experience that simplifies workflows and creates better member experiences,” said Pravat Rout, CEO at Inovaare. “Our goal for the Universe Management Suite is to help health plans reduce the cost of audit preparation by at least 50 percent.”

Out-of-the-box Efficiency

Traditionally, health plans commit resources for months while setting up all the data to comply with regulatory audits. Inovaare optimized the implementation process so that health plans can start using this powerful CMS universe validation and report generation tool within weeks. With the Universe Management Suite, health plans can scrub their data, validate clean universes faster than ever and submit consistently compliant regulatory reports that match the CMS formatting requirements. Health plans can also keep monitoring their universes by running Universe Scrubber monthly, weekly or even daily.

Proper Formatting Merely the Key

Getting universe tables properly formatted is merely the point of entry, and the Universe Management Suite helps health plans ensure their regulatory reports will be accepted by the CMS. But Inovaare’s CMS universe validation software completes the table analysis process by also flagging issues related to turnaround times, outliers and inclusion/exclusion criteria, which proves to the CMS that the health plan is properly managing its regulatory compliance responsibilities.

“Inovaare knows the world of Medicare and Medicaid health plans from decades of hands-on Regulatory Compliance department leadership and oversight, which is how we created this turnkey CMS universe validation solution with audit protocol changes included,” said Brenda Wade, Inovaare’s chief compliance officer. “And it’s also why the largest health plans in the United States trust Inovaare’s Universe Management Suite to improve their bottom line.”

About Inovaare Corporation

Inovaare transforms complex compliance processes by designing configurable solutions so healthcare organizations can collect real-time data across internal and external departments, creating one compliance management system. Inovaare’s comprehensive suite of HIPAA-compliant software solutions features best-practice regulatory processes to help healthcare organizations efficiently meet their unique business requirements, sustain audit readiness, reduce non-compliance risks and lower overall operating costs. Please follow us on LinkedIn at: https://www.linkedin.com/company/inovaare-corporation

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