About Us

ABOUT US

MISSION: We will provide the highest quality consulting services which assist our clients to achieve their prime success.
VISION: Addiox will provide recognized and advisory services to our healthcare and other IT clients through a multidisciplinary team using innovation, objectivity, and creative solutions.

At Addiox, we live by our mission and vision every day every moment and hold ourselves to the highest professional and ethical standards. Addiox is a consulting firm that specializes in developing technical and economic solutions that define product value to payers, hospital administrators, investors, providers, and patients. By using extensive technical expertise across the payer and purchaser landscape, our SMEs identify market drifts to position products for maximum patient access. We provides the very best SMEs to our clients nationwide and our specialists stay up-to-date with current product and technological changes/implementations and available consultants, finding the right person and the right opening as quickly as possible. Addiox is consistently inspired to exceed client expectations, and we are committed to establishing long-term working partnerships.

WHY US:

Why Addiox is different from other IT and economic consultancies? We approach all strategic and tactical development from the purchaser’s perspectives. Our company is mainly focused in serving clients in Healthcare & Lifescience companies around the country and help our customers to plan, formulate and execute various strategies in order to gain competitive advantage. We specialize in upgrading, optimizing, implementing health insurance industry’s claims administration systems like Health Edge, TriZetto and NASCO plus other related technologies and applications.

Addiox operates in following Horizontals:

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CORE COMPETENCIES

At Addiox, we create solutions that provide concrete benefits for our clients. Just like the clients we assist, healthcare is our only business. Our exclusive focus and immense experience drive us to revolutionize and build solutions which reduce time-to-market, increase proficiencies and meet compliance and regulatory objectives. Learn how Addiox can provide the right solution for your healthcare business.
1Health Information Exchange (HIE)
Computerization in healthcare is on a rising trend, creating a growing need for unified communication between provider, medical and RCM systems. Health Information Exchanges (HIEs) are a significant platform that permit system interoperability and deliver a complete view of each member or patient transversely the entire care variety. Addiox has a comprehensive HIE solution that can handle these workflows in multiple formats, including HL7, HIPAA EDI X12, DICOM and NCPDP. With our principal expertize, Addiox can promptly help you develop integration facilities and implement HIE platforms, including consulting, analysis, design and configuration. Our profound expertise in standards-based integration and healthcare data enables our clients to provide to the market more quickly and with grander quality.
2Revenue Cycle Management (RCM)
While technology has added greater efficiency to the Revenue Cycle Management (RCM) process, Addiox confidently believes that the right RCM strategy accurately drives better financial performance. Addiox’ have proven track to improve financial performance and long-term sustainability across provider and payer organizations. So healthcare provider doing the billing can follow the process and address any issues, allowing for a steady stream of revenue. Addiox healthcare SME’s have experience evaluating leading RCM products and engaging directly with customers to implement the best revenue cycle strategies. As a result, we can offer supreme expertise in standards-based healthcare data and business processes to help our clients get ideas to execution rapidly. We also have outlined the optimal revenue cycle metrics that are most critical for a healthcare provider. Our comprehensive RCM services ensures that your revenue opportunity is maximized.
3Pharmacies and Pharmacy Benefits Manager (PBM)
Healthcare reform has positioned industries under increased pressure on drug utilization management for Pharmacy Benefit Managers (PBMs) and pharmacies, alike. PBMs operate in a price-competitive situation, under force to manage drug spending and increase the cost-effectiveness of medications. Pharmacies, in turn, are competing to upsurge the value they provide to consumers. Entities need closer data assimilation with PBMs (as well as with providers), and better access to pertinent clinical data. This value-added data availability, shared with properly applied real-time analytics, offers the perfect mixture for success. Addiox solutions are aligned specifically to address these challenges. Our services are proven to help improve process efficiency and product quality.
4Wellness & Disease Management
While Wellness and Disease Management programs continue to grow with strong sponsorship from newly formed Accountable Care Organizations (ACOs), they can take time to produce noticeable cost savings. High throughput in payer enrollment may purify some programs less effective and present new challenges in segmenting the population. Added features, such as benefit plan design changes, accessibility of new or generic drugs, and new clinical expansions, are out of the program’s control and may lead to the perception of easy ROI.
5Application Development & Management (ADM)
Architecture Consulting Application Development, Customization, Enhancement and Support Global Delivery Model (GDM) - Onshore / Offsite / Offshore delivery model System Migration Services Enterprise Application Integration Services Business Intelligence & Data Warehousing Business Analysis & Documentation Project Management & Program Management Business Rules Engine Implementation
6Medicare Services
Our realistic involvement, best-in-class technology and subject matter expertise empower us to provide superior results for our client critical services, including:
• Enrollment, Eligibility Management and Reconciliation (CMS & Medicaid)
• Premium Billing
• Claims & Encounter Processing
• Member/Provider Call Services
• Encounter Reporting
• CMS and State Reporting
• Financial and Capitation Reconciliation
• Print Fulfillment
• Compliance Tracking & Assistance
• Medical Management
7Accountable Care Organizations
Payment and delivery models in healthcare are undergoing a seismic shift in the United States, where Centers for Medicare and Medicaid Services (CMS) have driven movement toward Accountable Care Organizations (ACOs). Now, a large number of hospital systems and health plans are joining forces to create private ACOs and Physician-Hospital Organizations (PHOs). The anticipated result is better care coordination, leading to better quality outcomes and lower healthcare costs. However, the IT changes for these new business models will be an enormous undertaking. Systems that currently rely on minimal communication from health plans and providers will need to become tightly integrated. Data flows must be not only seamless but also consistent. This will require new applications, new interfaces or significant changes to both. With a breadth and depth of working with over 100 healthcare organizations, Addiox can deliver innovative business and technology solutions and services that enable quicker, high-quality solutions for your ACO, PHO and Integrated Delivery Network (IDN) initiatives.
8Cloud Health
Addiox offers inclusive cloud computing architecture and engineering services to healthcare IT vendors. Addiox Cloud practice support our clients in both providers and payers benefit from the use of cloud services:
For Providers
• Stress-free access to patient data for improving clinical outcomes
• Association between hospitals, labs and clinics
• Scalability and flexibility as storage volumes increase
• Saving of data center management overhead expenses
9For Payers
• Competence in processing claims and administration through consolidation of data systems
• On-demand scaling of computing infrastructure to meet higher workloads
• Conducting architecture gap analysis for applications for cloud migration
• Assessing the cloud computing platforms based on technology and business needs
• Providing engineering services to re-architecture / re-factoring of healthcare applications Supporting deployment and maintenance of healthcare cloud applications.
In this environment, cloud computing offers a way to achieve both economy and efficiency. Cloud solutions offer tremendous value for today’s healthcare industry. On top of direct cost saving from reduced capital expenditure, cloud computing helps improve information access and management. At Addiox, we have deep expertise in standards-based healthcare data services and the business processes required to manage them. We can help apply cloud solutions to your business and ensure the data security, accessibility and savings you need.
CLAIMSPLUS: ACCELERATING PAYMENT PROCESSES WITH AUTOMATED APPROVAL TOOLS

Our Product CLAIMSplus do for you?

  • Deliver robust claims management solutions
  • Automate employee benefit plans
  • Verify benefits’ offerings
  • Customizeautomated systems for Healthcare Payer and TPAclaims
  • Eliminate duplicate billing
  • Auto-flag inaccurate medical codes, or lack thereof
  • Process and reimburse NJVCCO claims
  • Tailor data analytics reporting
  • Strictly adhere to filing deadlines
  • Comply with HIPAA regulations and PID standards
Claim Requisition

Claim Requisition

Claim Review

Claim Review

Claim Estimation

Claim Estimation

Claim Processing

Claim Processing