Transform The Way

You Manage The Cost Of Care In Your Network

Bring more cost-effective care to your members through technology-enabled improvements in your core care and utilization management functions.

Provide Cost-Effective Care To Members
With Innovaccer’s Cost Of Care Solution

Engage your providers and members to enhance your core care and utilization management functions and drive medical and admin cost savings. The solution unlocks value for health plans across a range of areas from care management to referrals to prior authorization, among others.


Drive network keepage & appointment adherence


Insights on SDOH


Closure of coding gaps


Improve prior authorization processes & outcomes


Empowered & engaged providers and members

Heathcare's First Tool For Payers to Evaluate All The MA Plans Across US

Assess the success rate of your MA Plan and get insights into devising strategies.


Close The Coding Gaps

Assist providers to eliminate coding gaps. Follow up with providers to ensure prompt closure of outstanding coding gaps flagged at the point of care.

  • Respond to provider comments noted in coding gaps point of care solution
  • Compare the remaining gaps to those flagged at the point of care
  • Engage providers to close remaining coding gaps
  • Dashboards to track coding gaps performance

Unlock Improved Care Management Outcomes

Take your provider’s care management initiatives to the next level. Drive improved outcomes with enhanced care coordination and engage both providers and members on shared care objectives.

  • Engage members and providers on actions they can take
  • Empower members with educational content and other care support resources
  • Evaluate member clinical risk and needs with assessments and surveys
  • Leverage longitudinal care insights across all encounters and procedures

Activate SDOH Insights For
Member Needs

Look beyond clinical data in proactively identifying and addressing the social determinants of health of your members to drive downstream health outcomes.

  • Identify high-risk members with SDoH risk score
  • Enroll members in community resources
  • Engage providers with SDoH assessments and referrals to resources
  • Measure outcomes with performance dashboards

Close The Referral Loop

Put a stop to referral leakage in your network. Follow-through to schedule referrals placed by providers and engage members to reduce no-shows and improve adherence to pre-visit requirements. Close the loop by sharing specialist visit details with the referring provider.

  • Schedule referrals placed by the provider
  • Automate outreach and targeted care manager engagement
  • Share specialist visit details with the referring provider
  • Track and support referral performance at each step

Streamline The Prior
Authorization Process

Improve the provider experience with an in-workflow point of care prior auth interface, paired with streamlined review systems and processes for your UM team.

  • Dynamic logic against clinical criteria to unlock automated responses
  • Service-customized forms
  • Seamless provider - UM team communications
  • Worklist and dashboard views

Learn how Inmediata Health Integrated Solutions streamlined their care delivery processes and utilization of resources with Innovaccer's healthcare data platform.

A Collaborative
Approach To Meet
Payer Priority Needs

Innovaccer focuses on driving more collaboration and connectivity in the healthcare ecosystem by providing an integrated solution that addresses payer needs by focusing on critical, overlapping needs across the value chain.

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