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Redox for payers

Get complete data for closing gaps in care

Analyze real-time, longitudinal data from claims, EHRs, and digital tools to improve outcomes

Stratify member risk with precision

When your members see multiple doctors and specialists, it’s difficult to see a complete picture of their health. But with the right interoperability platform, you can collect your members’ health information throughout their entire care journey.

With the ability to exchange data with virtually any provider EHR, healthcare information exchange (HIE), payer platform, or digital health vendor, you can target high-risk patients, close care gaps, and avoid costly health complications along the way.

Expand your integration reach to improve member care and experience

Exchange health data to complete a wide array of workflows

Prior authorization and utilization management

There is a growing number of outstanding prior authorization and utilization management solutions on the market today. Redox can connect any of them, or your home-grown solution, enabling a truly end-to-end prior authorization process. The promise of reduced administrative burden for you and your provider partners, and improved experiences for your members is closer than you think.

Improve member engagement

Predict member needs and preferences, and deliver a cohesive, personalized patient engagement experience across the care continuum.

Care coordination

Ensure the patient record is comprehensive, and care handoffs are effective.

Care management

Improve the patient-provider experience, and streamline day-to-day operations.

Manage population health

Develop a population health strategy to address chronic care management and meet the goals of value-based care.

Medical record retrieval

Modernize risk adjustment, improve NCQA HEDIS and CMS Star quality ratings, and streamline reimbursement audits with Redox’s secure electronic medical record retrieval from provider partners. Redox helps you get the data you need now, in real-time, at a fraction of the cost of manual retrieval.

Revenue cycle management

Optimize and streamline the management of reimbursements and payment processing.

Why choose Redox?

Exceptional technology

  • One comprehensive, EHR-agnostic interoperability platform
  • Capabilities refined over 9K integrations across 90+ EHRs
  • Huge scalability, processing more than 32M data transactions each day
  • Pre-built Redox configurations to accelerate your project timelines

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Deep healthcare expertise

  • Decades of health data, EHR, and enterprise system experience
  • Workflow mastery across disparate EHRs, APIs, cloud vendors, payer source systems, and digital health tools
  • Expert normalization across data standards including HL7® v2, DICOM®, X12®, CDA/XML, JSON, HL7® FHIR®
  • Full-service integration spanning implementation, adoption, and maintenance

Unmatched security

  • 100% cloud hosting
  • Certifications: SOC 2® and HITRUST® r2* (audited by PwC)
  • Regulatory compliance with GDPR, CCPA, and HIPAA
  • A public bug bounty program managed by HackerOne

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What our customers say

Wellstar Health System logo

Any business unit that can use real-time insights to drive service and experience improvements will get value from the foundation that we have created with Redox and Microsoft. It will help us dramatically reduce the latency from insight to action and deliver better care for our patients.

Rob Zanin
Executive Director of Digital Consumer Products, Wellstar

Brigham and Women's Hospital logo

We’re eager to be better partners to our colleagues at digital health startups and large vendors alike. This platform will allow us to efficiently and securely share information and data that are essential to supporting the development of novel technologies that have the potential to ultimately improve the care of our patients.

Adam Landman
CIO and SVP of Digital, Mass General Brigham

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