Get the right data, in real-time.

Redox transforms health plans into central purveyors of member data.

The Redox for Payers interoperability platform can help you take the lead in changing healthcare through real-time data exchange with virtually any provider electronic health record (EHR), digital health vendor, and much more. Redox helps you move past legacy protocols into a world of complete member visibility even as business objectives, technology, and legislation change.

 

Redox for Payers use cases

Streamline prior authorization

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.

Case Study

Close gaps in care

Drive clinical and cost outcomes and build trust for greater value based care adoption by enabling bi-directional data exchange with contracted providers. Redox helps you collect the clinical and social determinants data you need to identify care gaps in real-time and facilitates the communication of your recommendations to care teams directly within their EHR workflows.

Simplify 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.

Compose in the cloud

Cloud-native analytics can unlock the power to fix healthcare, but you’ve got to get the data in there first. The process of mapping, normalizing, and converting data from EHRs and payer systems of record into formats ingestible by cloud vendors can be complex and lengthy. Some consulting agencies may charge millions to get the job done, but with in-depth expertise, Redox for Cloud shortens this process from months to just weeks, for a fraction of the price.

+ many more

If you can imagine it, we’d love to help you achieve it!

A single connection and API for all data exchange

Move beyond protocol today

Managing the ingestion, normalization and filtering of clinical and administrative data across multiple protocols (HL7v2, XML, API, C-CDA, X12, FHIR etc.) is daunting for even the most technically advanced organizations. Redox for Payers manages this complexity so you can re-direct your focus to composing differentiated experiences for your members and contracted providers. We connect you to any ONC-approved standard for both incoming and outgoing messages, and allow you to interact with them through a single Redox API.

Future proof for tomorrow

HL7® FHIR® offers tremendous promise in pushing healthcare toward a single, interoperable standard. While we know the transition to FHIR will take the industry several years, the Redox FHIR API will help you get started with FHIR to future proof your workflows.

Redox FHIR API References

Find provider partners already connected to Redox

Search the network

2300+

Provider Orgs Connected to Redox

350+

Healthcare Products in the Redox Network

85+

Compatible EHR Systems

Payer Resources

WhitepapersFrom Payer to Leader

Don’t just survive change. Shape it. Health plans’ unique view into the patient care journey makes them well-positioned…

WebinarsRadical Interoperability: Redox for Payers product launch

Payers that embrace radical interoperability to move their big data and digital transformation strategies forward will be positioned…

WhitepapersPayer Interoperability Jobs-to-be-Done

Interoperability with partners across the healthcare landscape will enable payers to comply with CMS mandates, while also opening…

Why Redox?

Once you connect with Redox you can be confident that you have an expert integration partner who is committed to accelerating your integrations, reducing overhead, and navigating complexity. We have an A rating from KLAS Research and will support you through each step of the connection process.

Speed

Redox enables real-time clinical and administrative exchange in just weeks.

Support

Our team of experts gets you connected, and keeps you connected 24/7.

Security

HITRUST certified and SOCII compliant are just the start of Redox’s security-first culture.