This article serves as a guide for how to review your submitted claims on Inovalon’s Claims Management Pro portal, which you can access here: providercloud.inovalon.com. This guide assumes you have completed the Inovalon Onboarding process and have been set up with access for Claims Management Pro.

Inovalon Help Resources

Inovalon has a host of resources available to aid with understanding their process. You can find these options in CMP under the “Training” Menu.

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• The Inovalon User Guide is an excellent resource to understand individual areas of the Inovalon CMP interface. We strongly encourage you to download a copy of this.

  • Up to date copies can be found under the “User Guide” selection in the Training Menu.

• The Interactive Training section provides links to several valuable resources, but in particular we’d like to point you at the “QuickStart Live” series, which covers all the basic areas that a regular user would want to be aware of. Much of the advice listed here in this article has been pulled from these resources.

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• QuickStart LIVE series (Need to be logged into CMP to access these links)

  • Quickstart Live: Reviewing Submitted Claims - https://providercloud.inovalon.com/supportsite/help/pages/claims-management-reviewing-submitted-claims-quickstart-live-0

  • Quickstart Live: Working Errors on CMS-1500 claims - https://providercloud.inovalon.com/supportsite/help/pages/claims-management-working-errors-on-cms-1500-claims-quickstart-live-0

Adding and Managing Users for Claims Management Pro

Click the following link to find a dedicated article on how to add and manage users for your office in the Claims Management Pro portal:Inovalon - How to Add and Manage Users on Claims Management Pro

Sending and Rebuilding Claims

Once you have created your claims in MacPractice’s Ledger as described in eClaims - Creating an Electronic Claim, you can navigate to the eClaims Ability. You can send any claim that’s in the Ready bin in the eClaims Ability by clicking on the Ready tab, selecting the claims you want to send in the claims table, and then clicking the “Send” button:

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In some cases when troubleshooting claim rejections, after making any corrections to the charges associated with a claim, you can use the “Rebuild” button to re-create claims for re-submission.

Click here to learn more about the eClaims Ability in general: eClaims Ability - Overview

Locating your Claims on Claims Management Pro

To find your Claims on the CMP Portal, you’ll look for the Claims Menu:

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From here, you can find your Institutional and Professional claims, and you can also review specific batches of claims in the Batches selection. A batch is created whenever you click the Send button, and will contain the claims that you selected when you sent them.

How long does it take for claims to appear on Inovalon after sending them?

If your claim batch does not appear on CMP, it can take up to a few hours for batches to appear depending on Inovalon’s load at the time. You can verify that the file upload from MacPractice was received by navigating to the System Menu > File Manager when logged into CMP.

Once you’re in the File Manager, you’ll open the following folders and see if there are any files in the Import folder:

Partners > Mac####### > Imports

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Viewing Claim Statuses

Institutional and Professional Claim Statuses

This table is from pg. 137 of the Inovalon User Guide:

Remit Payments and Remit Details

In the Collections Menu, under Remit Payments and Remit Details, you can find your EOBs and ERAs.

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Creating Timely Filing Appeal Letters in CMP

You can learn how to create Timely Filing Appeals here:

Inovalon - Creating and Managing Timely Filing Appeals in Claims Management Pro