For many hospitals, Utilization Management has shifted from a patient-centered service to an administratively frustrating body of work.
CORTEX® changes all of that. CORTEX starts with real-time EMR data, centers on predictive analytics, and ends in a technology platform that gives hospital staff a clear view of medical necessity for each patient. CORTEX also acts as a conduit with your payer partners, enabling a new level of collaboration and communication.
Improved EfficiencyTraditionally nurses start at the top of their daily census and work their way down treating the daily census as an all-or-nothing approach, giving all cases an equal priority. CORTEX uses artificial intelligence and machine learning to identify cases that are most likely at risk to help nurses spend more time on the cases that need the most support.
The average CORTEX client sees a 30% efficiency gain. |
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Better Payer CommunicationsCORTEX helps payer relations be seamless and collaborative. With CORTEX, payers and providers see all of the patient’s data per encounter in real-time without the need for faxes, emails, or phone calls. CORTEX acts as the source of truth on medical necessity for each case, bringing payers and providers together to review cases with the same analytics and insight.
Up to 40% of inpatient cases can be automated with 99% accuracy |
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Inpatient ConversionsCORTEX predicts appropriate status of a patient based on the patient's labs, vitals, medical history, orders, meds, and procedures. If the recommended status is different from the current actual status, the UR team will be notified of the conflict and empowered to take action.
An appropriate Observation rate reduction of 8.7% is typical for CORTEX users in their first year. |
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Denial Risk |
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A denial costs the hospital money, wastes the time of a physician advisor, and can reflect poorly on the hospital. CORTEX uses evidence-based medicine to help find patients set as INP that may not have the clinical documentation to support Inpatient status. CORTEX gives real-time alerts when a patient's status does not equal the patient's clinical conditions.
32% Denial reduction is common for many CORTEX users. |
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CASE STUDY
XSOLIS partnered with CMC to quickly and decisively get their facility live with utilization review technology to support their team before another vendor's contract ended.
CASE STUDY
By "offering my staff a tool that helps them be more patient-centered and focused, [XSOLIS] is worth everything to us," says Michelle Allen.
VIDEO
Renee Dunagan, Supervisor of Case Management at CMC in Victoria, TX, shares the impact CORTEX has had on her hospital.
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