Medical Solutions

Easily Insource Claims Repricing with ExpionIQ® Medical

The Smart, Seamless Way to Manage Non-Network Claims In-House

Forward-thinking health insurers and TPAs are increasingly insourcing management and repricing of non-network medical claims (claims that are out-of-network or priced using RBP) to stay ahead in the market. With the right technology, streamlining your transition to an in-house management model doesn’t have to be daunting. Expion Health’s Insourcing Solutions, including the ExpionIQ Medical platform and the ExpionME app, empower your in-house teams to seamlessly shift to insourcing and efficiently manage non-network claims — giving you total control over your strategy, data, and performance outcomes.

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Harness the Power of ExpionIQ Medical

ExpionIQ Medical equips your team with the tools to manage, reprice, and settle non-network claims smoothly and confidently. This technology suite includes everything from pricing technologies to comprehensive claims handling—without the need to develop your own systems. Gain direct access to proven solutions built for and by industry experts.

Benefits:

  • Flexible pricing terms to fit your needs
  • Total transparency and full control over your claims
  • Maintenance-free technology solution
  • One solution for non-regulated and NSA/state-balance billing regulated claims
  • Direct access to technology that industry leaders use

Key Features of ExpionIQ Medical

Price Optimizer

Make informed decisions with smart, dynamic calculators and advanced algorithms for fair and highly defensible data-backed pricing. This includes the Intelligent Allowable calculator for non-regulated claims and the QPA Calculator for NSA and state-balance billing regulated claims.

Workflow Manager

Streamline claims tracking, negotiation, and appeals, all within a cloud-based, user-friendly platform. Manage your claims inventory in accordance with regulatory timelines and with efficiency and ease — enhancing productivity and accuracy.

Performance Analyzer

Optimize your approach and improve favorable outcomes. Access real-time insights into your claims management processes with detailed analytics including discount rates, benchmarks, and success rates.

Enhance Member Support and Reduce Customer Service Burdens

The ExpionME app provides critical support for members facing balance bills from providers. This mobile tool not only elevates member experience by offering on-the-go support, but also significantly reduces the strain on your customer service teams by addressing common queries and concerns directly.

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Embrace the future of non-network claims management.

Learn more about how Expion’s Insourcing Solution can seamlessly integrate
into your existing operations to take control of your non-network claims.

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