End-to-end core administration

A configurable, rules-driven solution with demonstrated capability, flexibility and reliability.

The QNXT Enterprise Core Administration System is a configurable, rules-driven, end-to-end core administration solution with demonstrated scalability, flexibility and reliability. It supports multiple lines of business on a single core platform, including Commercial, Individual, Medicare, Medicaid, Duals, Consumer-Directed Health and Specialty. QNXT’s vast array of functions and full solution suite of modules include everything a payer organization needs to manage their data and operations, including:

• Medical and Specialty claims processing
• Claims re-pricing
• Capitation/risk fund management
• Premium billing
• Provider network management
• Group/membership administration
• Referral management
• Hospital and medical pre-authorization
• Case management
• Customer service
• Electronic data interchange

The out-of-the-box solution has deep rule-based features and functions that promote automation and accuracy. Built on an open platform with service-oriented architecture, the QNXT application delivers the flexibility and functionality necessary to improve performance and increase efficiency. It also helps you compete more effectively in the ever-changing healthcare market and positioning your organization to minimize financial risk and comply.

The latest introduction into QNXT is the new myQNXT functionality. Using drag and drop functionality, myQNXT gives users control over what they see, allowing them to create a customized view of layout and content according to their personal preference and job role. The myQNXT functionality provides the modern user experience that the new workforce has come to expect from working with technology.