Critical access hospitals have unique challenges that many other hospitals may not face. With fewer staff and greater revenue sensitivity, Utilization Management teams (or the staff member covering UM) at critical access hospitals do not have time to fight denials, wade through EMR records, or create in-depth reports.
Traditional Utilization Management tools are not tailored to help critical access hospitals with many of these key issues. Fortunately, CORTEX approaches UM from a different perspective - a perspective that better fits the way Critical Access Hospitals operate.
Revenue IntegrityUtilization management directly impacts revenue by getting cases into the correct status as quickly as possible, expediting the review process, and minimizing denied claims and revenue-at-risk. |
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Robust ReportingCORTEX has advanced reporting capabilities, giving nurses and executives immediate insight into key trends such as observation rate, conversion rate, and missed inpatient-conversion opportunities. Ad hoc reporting within CORTEX gives your team the ability to track discharge readiness and missed conversion opportunities on a case-by-case basis. |
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Payer CommunicationCORTEX acts as the source of truth on medical necessity for each case in the utilization review process. CORTEX gives both payers and providers access to real-time data to quickly and accurately make decisions based on the case's clinical-merit-aligned analytics and insight. |
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Reduce Administrative BurdenCORTEX’s machine learning and predictive analytics equips teams with actionable insights for a simplified, more informed utilization review process.CORTEX uses artificial intelligence to reduce the manual processes for small multitasking teams with limited capacity to complete case reviews, manage denials, and payer communication. XSOLIS' Analytics analyzes disparate clinical data from electronic medical records so that nurses don't have to. |
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PO Box 681789
Franklin, TN 37064
Call us: 855.371.0867
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