CLIENT OBJECTIVES

1156

Provide operational excellence

1155

Improve quality care for beneficiaries

1157

Optimize resources to generate savings

746

CONEXIA SERVICE MODEL

1141

INDUSTRY EXPERTISE

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.

Conexia has a wide scope of expertise, with clients in public health, commercial health, workers’ compensation and various governmental care programs.

1139

TECHNOLOGY PLATFORM

Conexia has developed a core technology platform (ONE) that is customizable to meet the diverse regulatory requirements and operational processes for each client in each geography. In most cases, our initial implementation is an overlay on the payer’s existing technology ecosystem to create real-time processes.

The ONE platform includes numerous modules and is designed to be versatile for each client, from micro to macro processes.

1148

USER SERVICES

Conexia takes a customized approach to supporting the various users with each client. This approach allows us to focus on the preferred methods of contact for each client.

Our partnerships typically include specific service level agreements that allow the client to measure the effectiveness of our response. Conexia trains our staff to provide answers and solutions that focus on the usability of our solutions as well as general technical support.

1142

MONITORING AND CONTROL

Our analytic tools allow the client to explore real-time data about the population and the performance of Conexia’s solution. The metrics and indicators are customized to the client’s specific needs.

This management dashboard provides real-time decision support to monitor and improve operational performance.

1151

DEDICATED CLIENT TEAM

Our dedicated client team is there to implement, maintain and continuously adapt the solutions we deliver to clients.

Each client team is comprised of business analysts and technical staff, supported by the broader Conexia team. This structure maximizes impact while leveraging best practices.

746

BENEFITS

1224

Eligibility Verification

Verified by swiping a card or entering information into our portal.

1231

Care Coordination

All providers have access to the same data for an injured worker.

1230

Medical Management / Utilization Review

Application of evidence-based medicine at the point of care.

1229

Statutory & Management Reporting

Customized, real time reports; all data centrally located.

1228

Claims Processing

Real-time validation replaces claims processes.

1227

Provider Billing

Real-time authorization automatically generates an electronic invoice.

1226

Proactive Risk Control Analytics

Track injured worker health in real time & design automated interventions.

1225

Fraud / Abuse Deterrence

Business rules to detect potentially abusive activity in real time.

1242

Put the real-time adjudication solution to work for you

See why Conexia is the leading trusted software vendor in the global payer community.

More about our Real-time Adjudication

 

At Conexia, we use our deep industry experience to optimize the balance between quality of service for patients, administrative costs and medical costs.
Know more about our Real-time Adjudication for Workers' Compensation

A trusted leader in the global payer community