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. 

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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
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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
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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
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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.

Creating a Data-Driven Network Between Payers and Providers