AI Powered Medical Necessity Insights for Pediatric Populations 

Clinical information for Pediatrics 

XSOLIS harnesses the power of predictive analytics and artificial intelligence to make pediatric patient data actionable in real-time to help you make the right determination each time. XSOLIS ensures the right cases are handled at the right time, by the right staff or by exception. No longer do you have to wait for technology that serves your needs – with XSOLIS, you’re equipped to succeed. 

Improved Efficiency 

Traditionally 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 mostly like at risk to help nurses spend more time on the cases that actually need the most support. 

• ​Nurses can start on high-priority, high-risk cases to best utilize their time 
• Helps standardize workflows
• Patient data flows over from the EMR directly into the platform.   

The average CORTEX client sees a 30% efficiency gain.

Better Payer Communications

CORTEX 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. 

• Gets payers and providers on the same page using the same tool 
• Significant reduction in case touches, administrative work, and appeals burden 
• Cases are statused upfront expediating the review process 

Up to 40% of inpatient cases can be automated with 99% accuracy 

Appropriate Inpatient Conversions

XSOLIS Analytics give recommendations on the appropriate status of a patient based on the labs, vitals, medical history, orders, meds and procedures.  If the recommended status is different than the current actual status the UR team will be notified of the conflict. 

• 24/7 monitoring of all patient information 
• Find Inpatient opportunities as soon as the patient qualifies 
• Identify opportunities earlier in the shift to allow time for resolution 

 Appropriate Observation rate reduction of 8.7% is typical for CORTEX users in their first year.