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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Innovista Health Solutions’ Delegated Clients Generate Over $1.9 Million in Incentives in 2018

Incentives Linked to an Overall Increase in Population Health Management Program Scores Innovista Health Solutions is pleased to report that its delegated clients recognized a 19% overall performance improvement in Population Health incentive programs in 2018. This...