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Start your day with the cases that matter most.
A new category of utilization management software, CORTEX®, changes the way hospitals undertake Utilization Management.
CORTEX harnesses the power of predictive analytics and artificial intelligence to make patient data actionable in real time. CORTEX ensures that the right cases are handled at the right time, by the right staff.
Within the CORTEX family of products, Cortex.UR handles the specific needs of today’s UR teams.
Cortex.UR uses XSOLIS Analytics to predict the correct status for each patient. If the predicted status of a patient does not match the current status, Cortex.UR notifies appropriate members of the UR team.
By identifying status conflicts up front, Cortex.UR pinpoints appropriate conversion opportunities and locates denial risks.
Cortex.UR allows payer reviewers access to cases that have been escalated to them by the participating provider. These cases can be authorized concurrently or the status can be automated based on the XSOLIS' analytics recommendation.
Reviews are streamlined thanks to the patient dashboard that cuts through the "noise" of excess data in the EMR and allows nurses to focus on essential information related to medical necessity.
Cortex.UR is designed to make your team more productive, but it was also designed to have a positive financial impact on hospitals. Hospitals are leaving millions of dollars on the table by leaving appropriate inpatient cases as outpatient. Hospitals also spend tens of thousands of dollars on administration - supporting documentation, answering payers' questions, and fighting denials - when staff time could be focused on patient care.
By identifying Inpatient cases earlier and more consistently while giving payers access to all necessary information to reduce the number of denials, Cortex.UR has an early positive financial return for hospitals.
Cortex.UR identifies which cases need the most attention, helping nurses focus on cases that matter most.
For the cases that do need further review, Cortex.UR packages and presents all relevant data clearly and concisely, saving the nurse from wading through multiple pages of an EMR. CORTEX-connected payers can see this information directly, or hospital staff can share the clinical packet in just a few clicks.
Finally, Cortex.UR has in-depth reporting to help find where UR departments are excelling or may need to spend extra attention.
Precision Utilization Management means centering UM functions around XSOLIS' analytics.
With Precision UM, a patient is authorized as an Inpatient based on the XSOLIS analytics threshold jointly agreed upon by payer and provider. All cases above these thresholds are automatically approved as appropriate inpatients, drastically reducing administration.
Our payer-provider network is already nationwide, connecting hospitals and health plans across the country through CORTEX. As the network thrives, the impact grows.