Health Plans | ConXus Platform

Health Plans

Solutions for Health Plans Banner

With our innovative software and services, health plans gain insights into the health of their population while meeting NCQA and CMS requirements.

Key Benefits for Health Plans

White-label and configurable, the ConXus Platform is HITRUST Certified, meeting the highest standards for security and protection of health information. It includes:

  • Responsive-design, optimized for PC, tablet, and smartphone.
  • Seamless integration into your member portal with your branding.
  • Comprehensive management and outcomes reports.
  • Extensive data exchange capabilities in batch or real-time.

Our experience working with Medicare Advantage, Medicaid, Dual Eligible, Special Needs, and Commercial plans has created a set of tools and processes that help you drive engagement, risk stratify members, and comply with CMS reporting requirements. Our flexible delivery model allows you to combine internal and external resources and PDHI technology and services to meet your needs for:

  • Member outreach by phone, email, SMS-text, and mail
  • Health assessment completion by telephone
  • Processing paper questionnaires
  • Mailing reports to participants and providers
HRA Completion Process

Health Assessment

  • NCQA WHP 5 certified, meets the requirements for Health Plan MEM 1 standards.
  • Question sets specific to Medicare, Medicaid (adult and pediatric) and commercial populations.
  • Scannable bubble forms for completion on paper in English and Spanish.
  • Facilitated delivery option for completion by a health navigator.
  • Actionable member report and provider report summary available online, for batch printing, and in XML or PDF format for integration into your EMR.

Action Plans

  • NCQA WHP 7 certified self-management tools, meet the requirements for Health Plan MEM 2 standards.
  • Available in 13 lifestyle, disease management, and disease prevention topics.
  • Based on reliable research to help change poor habits into good ones.

Coaching System

  • Record and track member outreach activities.
  • Support health navigators for health risk assessment completion.
  • Deliver more effective and efficient coaching programs by managing appointments, setting goals, documenting encounters, delivering tailored information, and securely messaging with the member.