2023

ExpionIQ: Transforming Healthcare Cost Management

Entrant

Expion Health

Category

Technology Solutions - Insurance Solution

Client's Name

Expion Health

Country / Region

United States

ExpionIQ™’s innovative use of artificial intelligence and automation technology is revolutionizing the way healthcare payers manage costs. The complexity of the healthcare industry and the vast amount of data needed by payers makes it challenging to aggregate and utilize that data effectively to curb costs. ExpionIQ solves this problem by intelligently scanning all pricing options, analyzing multiple factors, and unlocking savings opportunities for pharmacy and medical claims.

One example of ExpionIQ’s powerful capabilities is the NSA Navigator module which provides a unique solution to the challenges posed by the No Surprises Act (NSA) for health insurance payers. ExpionIQ's NSA pricing engine analyzes industry, proprietary, and claims data, as well as every nuance of the federal NSA law or applicable State Balance Billing law to efficiently calculate a highly-defensible, compliant qualified payment amount (QPA). The complexity of calculating a defensible QPA is staggering. ExpionIQ's NSA pricing engine significantly reduces the risk of costly arbitration and non-compliance by delivering a comprehensive and compliant QPA calculations. The platform provides transparent insights that help actively manage costs, making healthcare more affordable for payers and their members.

ExpionIQ is an innovative, technology-driven solution for healthcare payers looking to efficiently reduce costs.

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