Clean, timely, identified claims data from a patient's insurer

That is Flexpa's most useful and differentiated feature. Other tools and mechanisms that provide claims data are often delayed weeks or months, whereas claims through Flexpa are available as soon as adjudication occurs.

Bill negotiation and financial assistance

Claims can represent an overwhelming financial liability for patients. For bill negotiation applications like yours, this net-new capability is incredibly empowering to offer the right assistance at the right time.
  • Synchronize patients' bills from payers without manual upload of claims images or PDFs, reducing the chance that patients drop off of your onboarding flows.
  • Remove the errors of natural language processing and optical character recognition from existing manual uploads.
  • Be kept up-to-date on new claims for a patient for up to a year, removing the friction of repeated user upload.

Clinical trials

For organizations and researchers running clinical trials, Flexpa's capabilities offer a game-changing advantage in both planning and execution phases.
  • Filter patients based on historical claims data during recruitment, ensuring that you bring on candidates who meet specific clinical criteria.
  • Monitor real time claims data for any other medical treatments the patient is receiving, ensuring there are no conflicts or interactions that could compromise the trial.
  • Accurately estimate the cost of various aspects of the trial, from patient care to medication and procedure costs.
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"Partnering with Flexpa has significantly enhanced our patient onboarding process at Curavit."

Joel Morse, Founder and CEO of Curavit

Health insurance carriers

Patient access may be compliance, but it can be so much more. Innovative payers nationwide are taking advantage of the new capabilities of the CMS regulation to better serve their members and reduce inefficiencies.
  • Synchronize claims history for patients during onboarding from their previous insurers.
  • Follow-up with the right institutions with accurate location records for detailed clinical information.
  • Identify higher-risk populations and guide them toward appropriate benefits, such as specialty virtual care partners.

ICHRA administration and management software

For ICHRA startups, Flexpa offers valuable insights and functionalities that can enhance the overall experience for both employers and employees.
  • Better understand employee healthcare needs, risk factors, and preferences through timely and accurate claims data.
  • Analyze healthcare cost trends, identify potential savings, and suggest adjustments to plan designs that are cost-effective for both employers and employees.
  • Establish benchmarks for your ICHRA offerings, track regulatory compliance, and ensure accurate reporting of your ICHRA solutions.

Medicare enrollment

As a Medicare broker, you look to advise patients on the best plans, given their unique history and needs. With Flexpa, you can serve these patients more effectively than ever.
  • Power your Medicare recommendation engine with detailed historical claims data allowing you to personalize and optimize the Medicare plan guidance you offer.
  • Enrich your member portal with real data about their plan usage over the course of the year in anticipation of renewal.
  • Validate existing Medicare plan that is active for a patient and includes a variety of clinical information related to that coverage.
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Value-based care organizations

In the world of value-based care, you aim to prioritize patient outcomes and the quality of care provided. Flexpa becomes an indispensable tool for VBCOs like yours.
  • Real time access to patient care episodes and journeys to guide your preventive and intervention strategies.
  • Refine and optimize Risk Adjustment Factor (RAF) scores.
  • Monitor clinical outcomes, patient satisfaction, and financial metrics to improve HEDIS measures and STARs scores.
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"Working with Flexpa has been a game-changer for us."

Stephen Farber, CEO of HealthHive, PBC

Other Flexpa uses

The value of Flexpa's connectivity is not limited to just the scenarios above and extends to a variety of other functions and tools:
  • Care navigators
  • Digital health solutions
  • Fintech applications
  • First-party health data aggregators and wallets
  • Life insurance
  • Traditional provider organizations

What we don't do

Claims data is not always what you're looking for. Rather than try and square peg a round hole, we want to make sure you're equipped with the right tools to solve the right problems from the wide range of interoperability and API products on market today.
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We'd love to discuss more about how claims and other payer data can enable and accelerate what you're building.