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USA
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UK
IndiaOverview
Partner with Innova Solutions to harness the transformative power of AI, data intelligence, and advanced digital solutions to optimize efficiency and drive sustainable business growth.
Drive Membership Growth
- Implement proactive engagement and retention strategies
- Boost CMS star ratings
- Offer personalized products
- Reduce acquisition costs
Elevate Customer Experience
- Enhance CSAT and NPS for members and providers
- Modernize contact centers and member portals
- Enable seamless, omnichannel interactions
Transform Core Administrative Operations
- Streamline workflows and reduce costs
- Enhance transparency across the value chain
- Optimize end-to-end payer operations
Enhance Clinical Outcomes
- Drive adoption of value-based care
- Improve population health, care management programs, and clinical decision-making
- Ensure network adequacy
- Reduce clinical complexities and costs
- Improve payment accuracy and prevent FWA
SEGMENTS
Customized Solutions for Each Payer Segment
National Payers
Blue Cross Blue Shield Organizations
Regional Payers
Dental Payers
Pharmacy Benefit Managers
HealthTech Partners
Solutions
Payers Solutions
Over the past two decades, Innova Solutions has formed strategic partnerships with like-minded industry experts who share our passion for innovation. Working together, we help our clients enhance operational agility, increase revenue, and maintain a competitive advantage.
Domain-Specific Solutions
- Business
Growth - Customer
Experience - Core-Admin
Processing - Clinical
Outcomes - Digital Engineering
Solutions - Enterprise
Solutions
Business Growth
Membership Growth (Medicare Advantage Focus)
Provider Lifecycle Management
Enrollment Analytics & Plan Design
Customer Experience
Member Experience Transformation
Contact Center Modernization
Price Transparency
Member Portal Transformation
Core-Admin Processing
Claims Orchestration & Modernization
Fraud, Waste, & Abuse (FWA)
Appeals & Grievances
Clinical Outcomes
Clinical Review & Decisioning
Care Path Analytics & VBC
Population Health Management
Medical Coding & Review
Digital Engineering Solutions
Gen AI Studio for Healthcare
Gen AI for SDLC
Healthcare Data Engineering
Digital Front Door
Digital Product Engineering
Interoperability
Enterprise Solutions
Cloud Transformation
Data Platform Modernization
Advanced Analytics
Application Modernization
Core Platform Modernization
SUCCESS STORIES
Automated Claim Submission
Enhances Accuracy and Efficiency for NY Dual-Eligible Beneficiaries
Optimizing Infrastructure to Boost Profits by 12%
The client is an independent third-party administrator that supports diverse group benefit plans and offers consulting services in the healthcare…
Enhanced User Experience by Reducing Response Time & Streamlining Content Management
The client is a leading BCBS Payer offering services to more than 17 million members.
Medicare Risk Adjustment & Plan Rating Solution
Reduced manual efforts by 20% & dramatically improved reporting accuracy
Medicare Advantage Core Administrative System
Reduced administrative cost for a leading health payer in the US by 10% to 15%
Integrate Claim, Member, Provider and Clinical Data into Corporate RTR
Integrated the health plan data as per the business need of a diversified, multi-national FORTUNE® 50 major health insurance provider…
Enhanced Client Submissions from State for NY Duals and Supplemental Minimum Wages
Integrated dual claims split and minimum wages information into replication process for claim submissions
Enhanced TPA’s Core Business Operations
Reduced cost of infrastructure-setup for an independently owned third-party administrator firm and increased profits by 12%
Sales Application to Enabling Users Shop for Healthcare Plans
Improved user experience for a leading BCBS payer by reducing response time while searching for agents
Integrating Plans, Members and Pricing Arrangements of Multiple Players in Existing Systems
Improved payment accuracy & relationship with providers for a major health insurance provider
Enrollment Management Solution for a Leading US Health Insurance Company
Improved the enrollment process a leading health payer based out of US and removed duplicate applications for thereby reducing the…
Middleware for SOA, Routing and Streaming (ESB)
Provisioning the infrastructure based on the enterprise and other application requirements
Developed Single Source System with Dashboards for Healthcare Technology Company
A highly robust, scalable and tool-agnostic solution
Insights
BLOG
Optimize Healthcare Revenue Cycle Management with Evolutionary Algorithm Approach
Optimize Healthcare Revenue Cycle Management with Evolutionary Algorithm Approach
Status of the Quadruple Aim in Healthcare
Quadruple Aim (QA) is a four-dimensional framework that has effectively been implemented into primary healthcare practice. Introduced by…
Innova Optimizes Service to Payment Velocity with Transformative Revenue Cycle Management Offering
Innova Optimizes Service to Payment Velocity with Transformative Revenue Cycle Management Offering
Strengthening Healthcare Provider Security by Implementing a Vulnerability Remediation Program
Strengthening Healthcare Provider Security by Implementing a Vulnerability Remediation Program
The Innova Edge
End-to-End Technology & Talent Solutions
Top talent and emerging technologies to drive business success
A Comprehensive Ecosystem
Strong partnerships with key hyperscalers and proven expertise in digital product engineering
Deep Industry Expertise
Decades of experience in the payer industry with a thorough understanding of the regulatory landscape
Domain-Driven Solutions
Proprietary tools and frameworks to enhance speed, efficiency, and transformation
Payer Organizations
Payer Organizations
Healthcare Engagements
Years in Payer Services
Ready to Innovate with Us?