What is it?

APEX is an automated utilization review software program that is designed to provide a clinical decision on a treatment request in 30 seconds or less.

Why do I need it?

If you’re frustrated with excessive medical management costs, rubber-stamped medical decisions, unnecessary utilization reviews, and vendor referral leakage, APEX offers the technology that will alleviate all of these costly concerns.

How does it work?

The APEX software solution considers the statistical analysis of 50 million bills; multiple evidence based guidelines and applies your medical management strategy to deliver an accurate and immediate treatment decision.

What treatment requests should be sent to Utilization Review?

At little to no cost APEX can review every request on every claim and figure out which ones to send for utilization reviews.

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  • Within APEX we have embedded complex mathematical rules, which we call “Guideline Calculus”, to enable a “hands off” process that results in a quick evidence based medical decision.
  • With APEX we provide you a customized “Guideline Strategy” to ensure that the guidelines are stacked appropriately based on your company’s criteria, including jurisdiction, networks, medical management strategy… etc.
  •   As the industry leader we are so confident in our ability to provide superior technology and service, we guarantee it 100%.

Providing Help When You Need It

  • APEX offers a comprehensive auditing system which has the ability to securely store data and complete audits in real-time.
  • APEX offers a built in communication package with automated letter generation. The program includes advanced vendor notification and referral management services.
  •  APEX features an extensive reporting system that allows customized and ad hoc reports.