problem

Insurers lack timely, comprehensive patient data for effective continuity of care.

Health insurance carriers often rely on incomplete or outdated patient information from questionnaires, ADT networks, and Health Information Exchanges. These traditional methods lack the detailed data needed to accurately stratify risk, provide targeted care management, and ensure compliance with CMS regulations.

solution

Flexpa delivers instant, comprehensive patient data for carriers.

Flexpa provides health insurance carriers with instant access to clean, uniform patient data, including detailed claims histories. This enables payers to identify high-risk members at enrollment, offer proactive care management, and get ahead of the payer-to-payer data exchange mandate.

Flexpa across the patient care journey:

Identify high-risk members at the point of enrollment with detailed claims histories, enabling targeted health interventions and personalized care.
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Facilitate better coordination between care providers, ensuring continuity of care and optimizing health outcomes.
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Benefit from payer-to-payer data exchange mandated by CMS, ensuring a seamless transition to the official model when it becomes available in 2027.

Why Day 0 Matters for Member Experience

Seamless Onboarding:

Start personalizing member experience immediately with complete health history

Accelerated Risk Adjustment:

Start chart chase activities immediately, ensuring complete HCC coding from day one, eliminate redunant records requests

Operational Excellence:

Streamline care coordination and member support processes - show members you're prepared to support their health journey from day one

Shrink member claims onboarding from quarters to minutes

Get instant access to historical claims data to ensure continuity of care for your members.