QNXT healthcare
QNXT is a highly in-demand, flexible, and scalable claim processing software developed for payer organizations. It’s robust, rule-driven, highly accurate, and supports automation.
QNXT Enterprise Core Administration System supports multiple lines of business on a single core platform. Payers organizations use it to settle health plans, including Commercial, Individual, Medicare, Medicaid, Duals, Consumer-Directed Health, and Specialty.
Blue Eagle offers QNXT consulting services for payer organizations. We help you meet the health plan needs of increasingly diverse healthcare consumers.
Contact UsWhy Blue Eagle Consulting?
Blue eagle consulting firm specializes in healthcare IT consulting. We draw upon our top-class expertise in software and technologies to deploy software in our client’s organization. Our QNXT consultants have years of experience implementing and optimizing QNXT and other similar software.
We have deep experience with its full solution suite, including QNXT Claims Workflow, QNXT Core Administration, QNXT Utilization Management Workflow, and QNXT Appeals and Grievances workflow.
QNXT consulting services we provide
No matter the type of service you need, we are eager to serve you with equal dedication. Select from single or multiple services we offer.
FAQs
-
What is QNXT?
An astronomical number of patients make health plan claims every day. The insurance payers review and verify the claims and issue payments to the doctors or staff.
Health service providers or patients make claims, and payer organizations pay for everything covered under the health plan. Things may look simple, but complex software powers everything running in the background. One of that software is QNXT, a claim processing software.
It’s a piece of software developed for a payer organization to streamline its lines of business. Commercial, private, and government organizations use it to settle claims or provide reimbursements to their clients. QNXT makes it easy for a payer organization to work with multiple hospitals nationwide and support cashless transactions.
QNXT is an end-to-end core management solution that payers can use to manage their data and operations, including:
- Claim processing
- Billing
- Capitation/risk fund management
- Provider network management
- Customer service
- Electronic data interchange
-
What are your core consultancy services?
We provide a full suite of consulting services concerning QNXT. No matter the size of the project, you can contact us anytime. We cover:
- Workflows & Optimizations
- Build & Configuration
- Implementations & Upgrades
- Project Management Solutions
- Training
- Reporting & Data Warehousing
- Integration
- Managed Services
- Legacy Support
- Activation/ATE Support
- PM/Team Leaders
- Revenue Cycle Analysis
- QA/Testing
- Data and Analytics/Mapping
Need additional support not listed? Contact us today.
-
What are your QNXT Support Capabilities?
- Prior Authorization Support
- Staff Augmentation around UM/CM/DM
- HEDIS & Nurse Abstractors
- Clinical Coding
- Configuration and Plan Build for: Medicare, Medicaid, Medicaid Part D, Consumer Directed, Dental
- Crystal® and SQL Reporting
- Data Mapping and Extracts
- ICD-10 and 5010
- Testing and Quality Assurance
- Medical Management
- CMS Guidelines and Business Rules
- QSCI® and QMACS® Support and Training
- BlueCard™ (ITS)
- EDI – BizTalk®
Areas of Expertise
-
QNXT Implementation & Upgrade
Implement the full solution suite or only the modules that you need. After understanding your needs, we will plan an implementation process that causes minimal disruption to your current workflow. We can also help current QNXT users perform seamless integration of add-ons and supporting modules. We will take ultimate care to keep your business and provider data secure throughout migration, integration, or update.
-
QNXT Optimization & Configuration
You will see the maximum benefits of QNXT when we streamline your workflows and optimize your business processes. Our in-depth knowledge of the QNXT software allows us to make fine adjustments to the software for maximum output. We can optimize the software to reflect change in business rules, government mandates, technology, etc.
This can include the build and configuration of new business lines. We will provide managed core administration services to keep your servers and systems running consistently. It will keep the system running reliably and avoid any hiccup.
-
QNXT Training & Support
Our training programs enable your staff to use QNXT with high operational efficiency. We will teach the technical aspects to your staff members according to their interest and skill level. We will also provide constant support and answer any queries to help your staff members become excellent at using this software.
-
Project Management
Whether you are understaffed or expanding your services, we can manage your projects for you. Tell us what your business is trying to accomplish, and we will provide managed services for the project’s execution.
-
QNXT Data Analysis
We store data and create reports that you can to make crucial decisions. We analyze the data and relay it to stakeholders so they can use it to make informed decisions regarding policy changes and business strategies.
-
Legacy Support Services
We can support and maintain legacy systems. Our QNXT consultants can also help you modernize your legacy systems.
-
Utilization Management
Blue Eagle provides the consulting resources necessary to ensure the success of your utilization management project. We can help at any stage of your UM project, from planning and strategy to training support. Our consultants have years of experience in aspects of new implementations, optimizations, and conversions.
We have the special expertise to get the job done right and provide a seamless process. Our specific experience includes:
• Prior Authorization Review
• Hierarchical Condition Categories (HCC)
• ICD-10 mapping
• QA Audits/IRR
• Utilization Review
• Process Improvement
• Grievance and Appeals
• Auth. Chex and Resolution
• System Configuration and Optimization
• Updates to billing, coding, and utilization
• Business Rules, Requirements, and Documentation
• Case Management and Disease Management
• Staff training and nursing processes
• Clinical Chart Review
• Supplemental Staff for backlogsWe work with every individual client to provide consultants with the experience and knowledge that best match the specific needs of the project. We take care of the “heavy lifting” to ensure the successful implementation and use of systems. Our consultants also impart critical software knowledge to a client’s key employees—so that after the successful completion of a project, those employees have the essential skills that establish them as “super users”.
Contact us for all your QNXT needs
Blue Eagle offers full-suite consulting services for new and existing QNXT customers. Process claims faster to increase the satisfaction of your healthcare clients with seamless implementation and optimization of QNXT. Fill out this form to schedule a consultation.