Capital Rx, the enterprise health technology company and benefit administrator advancing our nation’s electronic healthcare infrastructure, is announcing Judi Health, the industry’s first unified claim processing platform capable of administrating pharmacy and medical claims for employer plan sponsors, health systems, and health plans on a single platform.
Judi Health combines pharmacy and medical claims administration workflows, paving the way for unified claims processing.
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Health plans and payers have never been able to effectively manage their members’ care holistically or control costs because of the disparate claim processing systems and workflows used to manage pharmacy and medical benefits. The U.S. healthcare system’s operational complexity and administrative deficiencies have led to a trillion dollars in annual waste.
“Solving some of the major challenges in healthcare will require us to address foundational issues with technology. Nobody planned to create two separate systems to manage pharmacy and medical claims, but an entire ecosystem has been cobbled together to maintain and capitalize on preserving inefficiency rather than advancing our nation’s care delivery,” said AJ Loiacono, Founder & CEO, Capital Rx. “The root cause of our nation’s failing infrastructure is massive underinvestment and inability for legacy companies to develop a unified platform for claims administration.”
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The Future of Benefit Administration: Unified Claims Processing
Judi Health will enable carriers, third-party administrators, and the U.S. government to centralize processes, improve the patient experience, and drastically reduce costs. Key features include:Judi Health combines pharmacy and medical claims administration workflows, paving the way for unified claims processing.
- Seamless, real-time patient and plan management for both pharmacy and medical benefits.
- Centralized operational, administrative, and financial services under one unified workflow, removing administrative waste.
- Enablement of innovative pricing and reimbursement models, including management of value-based care and contracting.
- Removal of the patchwork of antiquated systems and third-party dependencies contributing to inaccurate data, billing errors, lagging reimbursement payments, and soaring, highly variable costs for care.
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The ability to process pharmacy and medical claims is powered by JUDI, Capital Rx’s proprietary enterprise health platform. JUDI allows for the centralization of information and data and the synchronization of workflows that aid care coordination and improve access to essential, lifesaving medications and treatments. For example, cancer patients often face treatment delays from a few weeks to several months. Meanwhile, tumor sizes grow, conditions worsen, treatment becomes more costly and intensive, and patients face an increased risk of mortality. With a more modern, holistic pharmacy and medical claims processing system, employers, health plans, and providers can work together to deliver on the promises of precision medicine and value-based care.
“With Judi Health, payers will be better able to anticipate members’ needs, eliminate delays in processing and decision making to speed time to treatment for patients, and leverage the full power of gen AI to improve the patient and provider experience,” said Ryan Kelly, Chief Technology Officer, Capital Rx.
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“Over the last 25 years as a practicing physician and clinical executive, I have experienced firsthand the administrative burdens that come between doctors and patients. We are at a critical inflection point in healthcare, and the current infrastructure does not support the highest quality care at the lowest cost, said Sunil Budhrani, MD, MPH, MBA, Chief Innovation & Medical Officer, Capital Rx. “Judi Health offers a unique healthcare solution to enable seamless, transparent, modular, and efficient claims processing so that clinicians can return to focusing on what they were trained for – caring for patients.”
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Source – prnewswire
