Claims Management & Clearinghouse Solutions
Faster Payments. Fewer Denials. More Control.
Revenue cycle automation, powered by Inovalon’s market-leading technology, gives behavioral health agencies faster, cleaner claims and a stronger financial foundation.
Together, Qualifacts and Inovalon simplify claim submission, eligibility verification, and coverage discovery to reduce denials, speed up reimbursements, and improve visibility across the revenue cycle.
Unified RCM Workflows Directly from Your EHR
One Seamless Integration
Send, track, and manage claims and eligibility directly through your Qualifacts EHR with data automatically synced to Inovalon.
Fewer Rejections, Faster Reimbursement
Reduce denials and speed up payments by validating coverage, benefits, and payer details before claims are submitted.
Automation That Scales with You
Batch processing, payer rules, and real-time insights save your team hours each week and ensure claims flow smoothly.
Trusted Partnership, Proven Results
With Inovalon’s payer network and Qualifacts’ behavioral health experience, you gain both scale and expertise.
Claims Management Pro
Automate your claims for faster, cleaner payments
Claims Management Pro optimizes your entire claims process from submission to payment posting through deep integration between Inovalon and your Qualifacts EHR. With built-in payer validation, real-time tracking, and automatic remittance posting, you can spend less time managing rejections and get reimbursed faster.
- Reduce denials with payer-specific validation before claims are sent.
- Submit and track claims for all payers from one connected system.
- Post electronic remittances automatically for faster reconciliation.
- Gain real-time visibility into claim status and payment progress.
- Increase staff efficiency by eliminating manual uploads, duplicate entry, and tracking across portals.
Insurance Discovery & Demographic Verification
Find missing coverage, prevent costly denials
Automatically uncover active insurance coverage and verify client demographics before claims are submitted. With Inovalon’s powerful data network integrated into your Qualifacts EHR, you can reduce eligibility-related denials and capture reimbursements that might otherwise go unclaimed.
- Identify active primary and secondary insurance even when patients don’t provide details.
- Verify patient demographics instantly to reduce rejected claims.
- Improve cash flow by submitting clean claims the first time.
- Prevent write-offs caused by missing or inaccurate coverage information.
Eligibility Verification
Easily verify coverage before every visit
Confirm active coverage and benefits for every client with real-time and batch eligibility checks across hundreds of payers. Integrated directly into your Qualifacts EHR, Inovalon’s Eligibility Verification helps prevent costly rework and denials before claims ever go out the door.
- Run real-time or batch eligibility checks for faster intake and claim accuracy.
- Confirm active coverage and benefits across 650+ payers.
- Eliminate claim rejections caused by outdated or inactive insurance.
- Give staff instant visibility into eligibility results without leaving your EHR.
RCM Intelligence (RCMi)
Turn billing data into actionable insights
Gain real-time visibility into your agency’s financial health with Inovalon’s RCM Intelligence dashboard. Integrated analytics highlight trends, identify bottlenecks, and track KPIs like denial rate, days in A/R, and net collection rate, so you can make data-backed decisions that drive performance.
- Monitor revenue cycle metrics across all payers in one place.
- Identify and address denial trends before they impact cash flow.
- Benchmark your performance to industry standards.
- Improve decision-making with real-time, visual analytics.
Learn more
Fill out this form to request more information on our Inovalon integration.