DELEGATED SERVICES

OUR TEAM. YOUR PERFORMANCE.

As an Illinois-licensed TPA and a Blue Cross Blue Shield of Illinois and Humana Certified Management Service Organization, Innovista’s Delegated Managed Services provide a suite of capabilities to support risk and non-risk payor arrangements that will delegate all or a portion of operations required to manage their members.

Network Formation & Development

Facilitating the formation of new networks, assist in building comprehensive specialty networks

Eligibility, Capitation & Claims Processing, Customer Service Support

Eligibility Capture and Management, Capitation and Claims Adjudication, Customer Service Support

Utilization Management, CM/CCM/DM, & Quality

Pre-Authorization, Concurrent Review, Discharge Planning, Case Management, Complex Case Management, Disease Management, and Managing Quality Gaps in Care

Provider Relations, Financial Management, Management Advisors

Provider Education, Financial Reporting, Network Consulting to Improve Performance

Let’s work together to achieve better outcomes

Learn how Innovista can improve the performance of your delegated contracts.

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Stakeholders Seek to Drive Near 100% of Medicare Reimbursements to Value-Based Contracts by 2025

Willing Adoption Requires Provider Understanding of Growth Potential and Risks The U.S. federal deficit is the highest it has ever been. Healthcare makes up the largest portion of that deficit and the COVID-19 pandemic continues to amplify the issue. Over the past few...