Real-Time Adjudication, 4 Steps Reduce Costs for All Stakeholders

CONEXIA is an information technology company focused on the healthcare industry. Our service integrates all healthcare stakeholders redefining the control and administration of medical services, increasing efficiency and offering useful information for decision making.

 

The solutions we provide include the implementation of a real-time platform, that simplifies paperwork and processes and makes the communication between providers, payers, and other stakeholders simpler, more effective, and more efficient.

 

With the help of experts in medical care delivery, operations and information technology, we developed a core technological platform (ONE) that is customized to meet the diverse regulatory requirements and operational processes for each client in each geography. This platform also allows customization to the state, county, locality, and individual payer. 

 

With over 20 years of experience and over 250 global employees, Conexia has an unparalleled level of expertise with provider operations, clinical delivery, payer operations and technological solutions for each participant in the healthcare ecosystem.

 

With clients in public health, commercial health, workers’ compensation and various governmental care programs, we have a wide scope of expertise.

 

How it works

  1. The patient visits the provider facility and presents their beneficiary card which works much like a credit card. Eligibility is instantly confirmed, and the provider gets instant access to the patient’s record.
  2. While the patient is at the providers office the medical treatment request is processed in real-time through the interface that uses business rules to adjudicate the transaction based on evidence-based medical guidelines. Thus, the provider can make better and faster decisions.

  3. Payers and providers are connected in real-time, and patients can be made aware of their financial responsibility while at the provider’s office.
  4. The system automatically generates an electronic invoice for payment by the payer. Payment of invoices becomes prompt and simple.

Control medical and administrative costs while providing superior quality of care with customized solutions that adapt to your needs. Transform your healthcare practice.

 

Contact us to learn more about our technology solutions and support services:


 

Explore our Solutions for Healthcare Explore our Solutions for Workers' Comp

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