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. 

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Automate Case Reviews

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

  • Reduction in overall reviews of 18 – 30% 
  • Clinical Analytics reduce case touches required for standard review

Real-Time Access


Get real-time access to patient medical records 

  • Real-time access to clinical data 
  • EMR-agnostic interface and consistent experience for your staff 

Status Determination

Get guidance on the appropriateness of inpatient status 

  • Maximize appropriate status determinations 
  • Normalized view of clinical information 
  • All medical necessity clinical indicators highlighted 

Reduce Friction

Reduces friction with provider partners 

  • Create better user experience for provider partners 
  • Single source of truth for medical necessity 
  • Reduce concurrent manual review and retrospective P2P 

Proven-Time Savings 

  • 15-17 minutes  per case review (per national payer analysis)  

Webinar

Learn how Humana is driving change with their partners

Healthcare can’t remain a zero-sum game. XSOLIS CEO Joan Butters recently joined Humana SVP George Renaudin for an in-depth discussion on the state of today’s payer-provider relationships.

Their conversation covers three themes: zooming out to the status quo and why it can’t stand; zooming in to what XSOLIS and Humana are doing to transform the discipline of utilization management; zooming back out to how the industry can adopt this forward momentum.

Beckers Webinar Screen Shot