Real-time adjudication at the point of care
Workers’ compensation carriers, employers, government agencies and managed care organizations can transform the delivery of healthcare services with healthcare software solutions.
This video shows how real-time authorization at the point of care helps payers with the use of customized rules agreed upon with the payer client. The beneficiary data and eligibility status are instantly verified via the data capture point and the providers grant access to important information regarding the beneficiaries medical history and health status.
In this way, the beneficiary has access to more effective and more efficient care. At the same time, the Conexia service makes the providers work easier by minimizing unnecessary manual pre-authorization requests offering certainty of payment at the point of care and eliminating the need to file a medical claim for payment.
With Conexia a client can transform data into information for better decision making which allows it to, among other things:
- share and evaluate the beneficiaries medical history in real time,
- define and optimize medical service delivery processes,
- help ensure at the point of care the beneficiaries consistently receive the most appropriate services,
- prevent unnecessary, duplicate or potentially harmful care from taking place and proactively identify potentially abusive or fraudulent activity,
- generate administrative and medical savings.
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