The CortexRisk APIs

On top of the Cortex Analytics software, we have developed a set of REST-based APIs that are capable of supporting queries to verify various administrative aspects at the member or group of members level – this in order to enable functionalities such as: 

• Calculate risk score per member up to a point in time for a specific line of business (Medicare-Advantage, managed Medicaid, ACA, MSSP, and ACO REACH)Calculate change in calculated risk during and after coding a chart.
• Calculate risk score per member up to a point in time for a specific line of business (Medicare-Advantage, managed Medicaid, ACA, MSSP, and ACO REACH)
• Calculate change in calculated risk during and after coding a chart.
• Alert for proactive measures to prevent quality of service reduction at members’ level.
• Identify documentation and care gaps at the member level indicative of potential revenue opportunities as well as diagnosis codes that are not supported by clinical documentation that present potential adverse exposure to data validation audits.

CortexRisk API Benefits

• Outsourcing support and decades of expertise in healthcare legislation details and regulations.
• Save yearly logical updates and PS, per changes in regulation.
• No upfront  capital expenditure (CapEx) – API services are hosted on the cloud, API users are only responsible for OpEx costs.
• Fully HIPAA compliance and strict security enforcement.
• Automatic scaling up of API queries – Performance SLA is adapted to type and intensity of usag
• API is adapted to customer and client applications needs.