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A new standard has been set for communication and alignment for providers, payers, health plans, and provider-sponsored health plans. Ensuring appropriate care decisions shouldn't be subjective and time-consuming.
With CORTEX, there is a better way.
Hospitals realize reduced administrative burden in case review, creating efficiencies for their staff while ensuring the appropriate level of care for every patient. Through an AI-driven model that analyzes patient data from the EMR in real time, staff can standardize workflows and ensure objectivity in decision making.
Teams across the health system can access a real-time view of their patient census, prioritized by risk, that enables them to better manage length of stay, mitigate denial risk, and ensure proper reimbursement — all on one platform.
Payers, health plans, and provider-sponsored health plans (PSHPs) experience accelerated decision-making, increased collaboration with their connected providers, and even automated Inpatient and Observation status determinations. Leveraging historical, data-backed thresholds with XSOLIS' shared framework delivers real-time communication and more accurate views of a patient/member's clinical picture.
Accountable Care Organizations (ACOs) identify their ACO members and ACO REACH enrollees across XSOLIS’ connected network, and proactively receive clinical data communicating with providers securely to better coordinate high quality care across the continuum while reducing readmissions.
Partnering with best-in-class healthcare leaders
We are always pushing towards the future. As healthcare reforms and these things change, if we are not ahead of the curve, then we are going to be left behind.
Vice President of Case Management
We can’t collaborate about how to improve the health outcomes for our members and our providers’ patients if we’re not being collaborative with the data.
Sr. Vice President
The way utilization management works now is entirely different, and we’ve been able to do our best work. Our nurses are very happy and love their UM jobs.
Director of Case Management
The most compelling result is that the payer-provider relationship has thrived.
Revenue Integrity & Utilization Management Officer
Not only has the platform paid for itself, but it has obviously exceeded our expectations with reimbursement dollars as well as staff and clinical efficiencies.
—Mary Beth Mitchell
Senior Executive Director, Care Transformation Strategies
A fully optimized healthcare system that elevates the human experience and clinical expertise is not only possible, but attainable. XSOLIS applies the power of data science to ensure medical necessity and appropriateness of care across the healthcare ecosystem. We create efficiencies that open the door for more collaboration, partnerships, and transformation among our connected network of providers and payers.
CORTEX's real-time predictive analytics continuously assign an objective medical necessity score and create game-changing efficiencies for our customers — now bolstered with the most proactive data security and compliance measures available.
XSOLIS Introduces Precision Utilization Management
The power of precision medicine has been brought to utilization management. Learn more about what precision UM is and how it is being used by hospitals and health plans.
Chilmark Research Report:
Next Generation Utilization Management Through AI
Chilmark Senior Analyst Dr. Jody Ranck explores traditional processes used in UM and their challenges, and the application of AI and ML to build bridges between payers-providers.
How Does CORTEX Impact Financial Objectives?
An automated utilization management process gives organizations the potential for undiscovered financial opportunities. Read more about how CORTEX can yield financial results.