XO® seamlessly connects health insurance companies and third party administrators (TPAs) allowing for efficient, reliable, and cost-effective electronic claims processing. XO® consolidates different formats of medical, pharmaceutical, dental, and vision claims from multiple healthcare insurance carriers into a single TPA-specific electronic data file for claims adjudication and debit card transaction validation. XO® eliminates the need for participants to submit claims and automates substantiation and adjudication of HRA and FSA claims while eliminating the high costs associated with managing traditional point-to-point connectivity with multiple carriers.
Our experience with CXC has been mutually beneficial and has really made my life and that of our team's more rewarding in terms of our business. XO® has simplified our business.The ability to have claims data feeds is a competitive advantage in today's market. XO® allows us to work with markets and employer groups that we previously could not work with utilizing CXC simplifies the process of bringing multiple carriers into our format and within our system. - President & CEO, Leading Benefits Administrator
XO® has the ability to consolidate claims feeds received in various formats into one standardized data file that seamlessly integrates into the TPA's benefits management system.
Carrier feeds typically contain new claims in addition to reversals and adjustments.XO® has the ability to interpret these claim types and aggregate them to minimize the underpayment and overpayment to participants.
Adjustments and reversals to claims tend to arrive long after the original claim has been processed and paid out to a participant.XO® provides the ability to age (hold back processing) claims to reduce the likelihood of payment adjustments.
XO® will ensure that all valid claims that are unprocessed due to inherent time lag between enrollments in a carrier and TPA system are 'reprocessed' for payment. This ensures that no claims are left behind.
XO® supports data flow between multiple benefits systems and plans and TPAs (i.e. when one TPA or System manages the HRA plan and a second system manages the FSA plan).
The XO® web portal gives TPA customers services teams full visibility to the status of complex HRA or FSA reimbursements. With our web portal, your customer service representatives will always have the ability to answer questions quickly and proactively monitor feeds.