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The process of utilization management has been bogged down by administrative hurdles and a lack of interoperable technology, tying up resources and revenue for both payers and providers. With CORTEX, there is a new reality: technology that ensures appropriate reimbursement and appropriate status consistently and effectively.
CORTEX acts as the technology bridge between payer and provider, rethinking the process of utilization review. Data flows from the EMR and through our AI engine to CORTEX, offering intelligence and insights at your staff’s fingertips. Providers and payer partners can access the platform to concurrently authorize and automate case reviews.
CORTEX is the first AI-driven platform to serve the utilization management function: it harnesses machine learning, predictive analytics and natural language processing to reduce the administrative burden on your staff. CORTEX interfaces with all major EMRs.
CORTEX brings patient data to light and helps your UM staff assess appropriate status quickly and effectively. CORTEX stratifies cases by priority and sensitivity, allowing staff to focus on right cases first. CORTEX helps you seamlessly communicate with payers or connect directly with payer partners.
CORTEX brings patient data across your system – even across separate EMRs – together in one analytics-driven tech platform. CORTEX helps UR staff or physician advisors stratify and review cases quickly and effectively to get status right up front. CORTEX helps you seamlessly communicate with payers or connect directly with payer partners.
CORTEX goes beyond EMR access to allow provider partners to escalate member cases directly to your staff for authorization from within CORTEX. CORTEX can be used as a direct communication and authorization channel or it can be used to help automate a full subset of inpatient determinations, saving review time as well as appeal burden.
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