adjudication-rxagile.jpg

Adjudication that just works so I can focus on my business?

 

The way it's supposed to be.

RxAgile-Logo-Shadow-white.png
imac_new_rxagile_application3.png

When your claims adjudication engine works, that's great.

When it can also create efficiencies while helping you manage your business, that's RxAgile

 
background4.png

Security & Continuity

We are committed to a risk-based, multi-layered security approach throughout the environment.

ISO 27001

Information security standard that provides requirements for establishing, implementing, maintaining and continually improving an Information Security Management System (ISMS).

ISO 22301

Specifies requirements for setting up and managing an effective Business Continuity Management System (BCMS).

HIPAA

Protects the confidentiality, integrity, and availability of protected health information (PHI).

HITRUST CERTIFIED

A comprehensive, prescriptive, and certifiable framework that can be used by all organizations that create, access, store, or exchange sensitive and/or regulated data.

SOC 1 – Type 2

Report from audit on various organizational controls related to financial reporting.

SOC 2 – Type 2​​

​​Report from audit on various organizational controls related to security, availability, confidentiality.

security_edited.png
RxAgile is a cloud-based turnkey, white-label adjudication engine, with all the flexibility and simplicity needed to manage your business now and as it grows. 
 
Complexity simplified. Savings optimized. Business maximized.

"We are proud to be partnering with an innovations-driven company like RxSense."

 
background4.png

What does advanced technology feel like?

Configuration Innovation

What formerly required IT intervention and coding can now be configured easily through our intuitive user interface by business operations staff. With RxAgile, an eligibility change is made by direct entry to the live platform, or by dragging-and-dropping a file for immediate processing—and it's instantly available.

Single Source of Truth

Our API-driven platform keeps all the tools that support your consumerism strategy up to date. Whether it's member-pay pricing look-up, HDHP-support, or formulary changes—they are always current, in real-time, across the board.

Seamless Interoperability

Interoperability across our platforms, RxAgile and RxIQ (our reporting and analytics solution), and between legacy other healthcare systems means reliable access to the vital health information needed to support clinical processes and improve overall care delivery. Our APIs are JSON-based, RESTful-compliant, and meet the Fast Healthcare Interoperability Resources (FHIR) and NCPDP standards.

Branded Member Tools

Deliver the information members want in easy-to-use tools

 

Our member portal and apps are plug and play, brandable, and available to our private-label PBM clients. Since they are part of RxAgile, the information members need is real time and accessible once they log into their portal or mobile app (iOS and Android). Alternatively, if you have your own portal, virtually all of the member portal’s capabilities can be pulled in via APIs.

Pharmacy Locator

Limit display to only those pharmacies available to the client's / plan’s network selection

Robust Drug Search

Find drug information, interactions, along with  true member-pay price based on accumulators/benefit status

Secure & Compliant

HIPAA- and regulatory-compliant log-in displaying only the  information appropriate to the specific member ID

Claims History

In a single click, view claim details, Rx specifics, product particulars, patient information

 

Optimize your plans with real-time, operationally critical analysis and reporting – all within RxAgile

Easy-to-use, dashboard-delivered analytics with simple drill-down capabilities enable deeper insights and investigation. Imagine pulling ad hoc reports on exactly the data you want to see without having to contact development resources. That’s RxIQ®, our analytics environment integrated directly into RxAgile. Scheduled, standardized reports for delivery daily or monthly? No problem. They can even be configured and private-labeled for your downstream clients and delivered to their inbox as well as in a “news stand” environment.

background4.png
What else would you like to learn about today? 

 

Transformative Model

Transparency, control, flexibility are all long over due. We got here as fast as we could.

 

Interoperability

This is table stakes for us. Find out just how well we do this.

 

Service Model

We're here for you. In the way we wished our PBM was there for us and wasn't.

 

RxAgile

Dig into more details about the claims adjudication engine that could.

 

Business Accelerators

Whether you're new or been there, we've got an accelerator for you.

 

Security & Continuity

We're rather proud of all the badges we've earned and the downtime we haven't had.

 

RxIQ

Beyond reports, data, and analysis, find out what else RxIQ can do.

 

Strategies

Our recommendations leverage automation and machine learning.

 

Who We Are

Learn more about our leadership and why we decided to build these platforms.