Discover the power of a real-time point of care solution for Workers' Compensation

Conexia is able to engage providers through a variety of methods and platforms (access points). These access points strengthen the payer-provider partnership, providing the maximum benefits of the real-time connection.

Eligibility for a claim and/or treatment is instantly confirmed as per the injured workers’ claim status because the payer and provider are electronically connected.

If there is no claim on file, the injured worker or provider can submit a report of injury and request treatment.

The provider enters a code for diagnosis.

The medical treatment request is instantly processed via the interface, which uses business rules to adjudicate the transaction following evidence-based medical guidelines. This positively and prospectively impacts the patient’s care (as well as cost) by promoting adherence to medical standards at the point of care.

Payers and providers are also able to communicate in real time regarding additional allowances and disputes, supporting communication flows with legal representatives and external entities such as appeal boards or independent medical review organizations.

The provider is instantly notified of the action.

Providers have certainty of payment at the time of service because medical services are authorized in real time.

Additionally, alerts notify providers at the point of care (or before) regarding the implications of their care decisions relative to quality metrics, peer performance, and evidence-based / customized clinical guidelines.

There is no bill for the provider to submit because the medical transaction has been fully approved.

Payment of invoices becomes prompt and simple.

Conexia monitors the entire process and generates relevant quality metrics, while the payer has continual and complete oversight of all activity.