Improve Payer Provider Collaboration through CORTEX®

Get Real-time Access to Member's Clinical Information

XSOLIS' Utilization Review platform, CORTEX®, acts as a shared framework for case review between payer and provider - backed by analytics focused on the true clinical merit of the case. 

CORTEX for Payers gives payer staff a real-time view of each patient case escalated to them by the provider, expediting the review process while reducing redundancy - all without the need for digging through the electronic medical record. 

Real-Time Access

Hospital and payer teams have secure access to specialized, EMR agnostic views for standardization of clinical reviews

  • Real-time access to clinical data through specialty views
  • EMR-agnostic interface and consistent experience for your staff
  • Right Member and Right Visit are accessed at the Right Time to ensure success of an authorization request


Improve Payer Provider Collaboration

Payer staff have a real-time view of each member case, expediting the review process while reducing redundancy - all without the need for diffing through the electronic medical record.

  • Clinical updates are seen by both parties in real-time 
  • Payers and providers are looking at the same data 
  • Payers and providers can add comments about the health information and share bi-directionally
  • All data is kept securely in the cloud



Precision Utilization Management

When analytics are above a certain threshold, payer and provider agree to automated inpatient and observation approval. We call this Precision Utilization Management. You might expect:

  • Significant reduction in case touches, administrative work, appeals and peer to peer burden as cases are statused right up front
  • Payers typically save 20-25 minutes per case review based on the national average
  • Up to 40% of inpatient cases can be automated with 99%+ accuracy using Precision Utilization Management





Transforming the Traditional Utilization Management Process for Health Plans with AI: How Humana’s Next Level Collaboration is Driving Value Across the Care Continuum 

Eliminating administrative waste and reducing inefficient processes without impacting quality of care is top of mind for leading Payer and Provider healthcare executives nationwide. With this in mind, the traditional Utilization Management (UM) process is riddled with parallel efforts and duplicative processes that cause unnecessary errors, friction, and delays.
Hear from leaders at XSOLIS and Chilmark Research in this Becker’s Payer Issues webinar to learn more about breaking down the healthcare silos with industry-leading AI for accelerating data-driven decision making and collaboration across a connected network of Payers and Providers. We’ll also discuss Humana’s recent time study results including time and touch efficiencies gained in status determination over fax and working within the EMR.