MedExpert
Purchaser Intelligence.
Patient Health.
A new era in healthcare
Today's explosive growth in medical information — research, test results, records, claims — demands a new approach unhampered by manual processes and fragmented tools. MedExpert delivers a state-of-the-art healthcare decision and integrity system, adding intelligence to the spectrum of decisions required by patients and purchasers.
A New Era
in Healthcare.
An overview of MedExpert's approach — the platforms, the philosophy, and the decision intelligence that improves outcomes across the healthcare ecosystem.
Our platforms combine evidence-based medicine, integrity controls, and member-facing decision support — all built on data integrated and normalized within 24 to 72 hours of receipt.
Healthy members.
Healthy purchasers.
MedExpert improves member health and drives change by leveraging decision-making systems. Experience the full suite of MedExpert's Healthcare Decision Systems — AI-based platforms that keep current with today's frenetic pace of innovation, advocate for members, and help navigate the complex healthcare ecosystem.
MedExpert provides a configurable decision-intelligence platform, not a portfolio of separate products you have to integrate. Every deployment is shaped around the population you cover, the systems you already run, and the outcomes you're being asked to deliver. One platform, one source of truth, one team to work with.
The platform's capabilities — evidence-based clinical guidance for members, integrity controls before claims pay, real-time quality management, transparent cost and benefit explanations, member-facing advocacy — are documented as components on the Platform page so you can see how the pieces fit. In practice they aren't pieces. They're facets of the same system, drawing on the same data and the same clinical infrastructure. What changes from one client to the next is the configuration, not the architecture.
Decision intelligence at
every level of the chain.
Cost Control
Purchasers need rapid access to high-quality data — and to control waste, fraud, and abuse at every level of the decision chain.
Real-Time Insight
A data analytic system that allows for near-instantaneous insight into cost containment and quality improvement efforts.
Cost-Effectiveness
MedExpert's new generation of comprehensive DDS services is 5–15× less expensive than traditional alternatives.
Information Currency
Access to the world's leading practitioners and researchers via AI technology, kept current with the pace of medical innovation.
Data From Everywhere
Eligibility data is coupled with payer data from Medicaid, MCOs, children's, state-employee, prescription, dental, self-insured, private plans, and Medicare.
Safe & Secure
MedExpert is 100% HIPAA, HITECH, and federal/state regulations compliant — built from the ground up for trust.
Data Today
MedExpert integrates and normalizes data within 24 to 72 hours of receipt — actionable intelligence on a real-world cadence.
Real-World ROI
Our member-focused DDS system can reduce claim costs by more than 10% — and has repeatedly generated an ROI greater than 14:1.
MedExpert has no financial ties to any organizations that could influence patient decisions for financial purposes — no arrangements with pharmaceutical companies, provider groups, or hospitals that could present a conflict of interest.
An AI-based platform
that takes healthcare
to the next level.
Segmented healthcare programs — those that operate "in a silo" — have failed to reduce or control costs. The CBO has repeatedly found that disease-management and care-coordination programs fail to deliver real savings. Across roughly 30 reviewed programs, most could "save a dollar" — but it took a dollar to save a dollar.
The primary reason: most disease- and case-management programs are manually based systems. MedExpert invested more than a decade engineering EBM to cost-effectively deliver decision support, navigation, and data-analytic services that incorporate 100% of your data sources in near real time.
Because MedExpert's automated AI-based platform delivers evidence-based, beneficiary-focused clinical information across all known conditions, co-morbidities, and pharmaceuticals, no one is excluded from our services.
Trusted by trust funds,
employers, and public-
sector partners.
"In the last ten years, MedExpert has earned a reputation of trust with our membership. Our members rely on MedExpert."
"Other vendors talk, but they don't have the resources or commitment to make it work. MedExpert is committed to leveraging technology and engineering staff to solve issues."
"We love working with MedExpert. They always exceed our expectations."
Better information.
Better decisions. Better outcomes.
Provide every individual with current, unbiased, and accurate information to make the most appropriate medical and health decisions — for every man, woman, and child.