cortexsubro is the premier medical claims subrogation management platform specifically designed for government-regulated health plans. Built on cortexanalytics’ cortexETL, it is the only Extract, Transform, and Load (ETL) solution that enables user self-service loading of all data files commonly used by Medicare Advantage Organizations, Medicaid Managed Care Organizations, ACOs, and ACA Issuers.
cortexsubro offers unique features that allow health plan and law firm users to create episodes of care starting from the tort, accident, or event that initially caused the injury or illness. It then leverages predictive analytics to forecast future medical expenses using the extensive MarketScan® Commercial, Medicare, and Medicaid Claims and Encounter Database integrated within the cortexanalytics platform.
By predicting future medical expenses while accounting for the victim’s underlying health conditions through comprehensive risk adjustment and other analytical methods, cortexsubro assists plaintiff’s counsel in maximizing the recovery of funds from primary payers for both past and future medical expenses. It also ensures that adequate funds are available should a State Medicaid program seek to recover future medical expenses in light of the Supreme Court’s recent decision in Gallardo v. Marstiller.
If you’re part of a Medicare Advantage Organization, Medicaid Managed Care plan, or their representative, avoid handing your subrogation files to debt collectors who file frivolous lawsuits under the Medicare Secondary Payer Act. Such cases are often dismissed under Rule 12(b)(6). Instead, use cortexsubro to determine the present and future value of subrogated liability, allowing you to select the best cases to litigate or negotiate for the most favorable outcomes.