Improve Payer-Provider Collaboration with 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

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.

Improve Payer Provider Collaboration through CORTEX®

Get Real-time Access to Member's Clinical Information

Real-Time Access

Improve Payer Provider Collaboration

Precision Utilization Management

Webinar

Learn how Humana is driving change with their partners