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Redox for product teams / Use case

Connect your app to payers and insurance partners

Products and providers use Redox to maximize payer partnerships.

Compose your payer program

You’re helping payers to lower costs, deliver innovative, personalized experiences to members and improve population health outcomes. Whether you’re looking to sell your product to new payers or streamline workflows with your existing payer partners, Redox can help.

Read how Redox handles integration, so you have a solution for fixing prior authorization.

Streamline payer-provider workflows

Connect to payers and/or clearinghouses to digitize revenue cycle workflows including eligibility, prior authorization, claim, and payment.

Coordinate & monitor member care

Receive payer orders/referrals, exchange remote patient monitoring data, send lab and genomic test results, and more.

Engage payer members

Exchange member information to help payers improve member communications, and build outstanding experiences.

Provide care to payer members

Check eligibility, enroll members in your services, schedule appointments, receive patient demographic information, and transmit information about the care you provide back to the payer (e.g. CCD).

Close member care gaps

Harmonize payer and provider data to return insights that can be acted on to enhance population health initiatives, advance value-based care programs, and improve HEDIS/STARS performance.

Check eligibility & request payment

Confirm customer benefit eligibility, and send and receive claims and payments with payer partners and/or clearinghouses.

Improve your product pitches to payers

Get tips from health plan innovation leaders on what matters when pitching your product, and how to build long-lasting relationships after the sale.

Watch the replay for an inside look at how payers innovate

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Resources

Learn more about using Redox as the solution to your business.

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