GxRay™

Current State & Process Analysis Solution

Why GxRay™? Our approach is simple. Strategic planning saves time and money – obviating the need for rework and redesign of technical solutions during implementation – enabling projects to stay on schedule.

GalaxE ISO-12207 based GxRay™ methodology is a rigorous process that validates system functionality against business and technical requirements while identifying gaps.

80%

Faster than comparitive manual analysis

4x

Single engagement results in analysis and remediation

20+

100% based on standards such as ISO-12207, IEEE-1471, covers 20+

Globally Implemented at Fortune 20 Organizations and Higher

Product and Services for
  • Automated review and analysis of large enterprise systems (6-12 weeks)
  • Analysis data used for
    • Documenting systems
    • Performance troubleshooting
    • Compliance assessment
    • Remediation plan
  • Import claim history
  • Create, save, copy, and merge selection scenarios
  • Targeted drug lists with wildcarding
  • Targeted member lists with include/exclude
  • Targeted plan parameters
  • Add random selections for additional breadth
  • D.O adjudication ready output
  • Automated analysis of claim outcomes
  • Direct drill down to root cause claim components
  • Traceability to plan configuration and plan requirements
  • Organize, tag, and track claims by deficit ID
  • Pricing threshold settings limit false positives
  • Pricing comparison/analysis
  • GxCare™ integration
  • Typically a 4-8 week process depending on complexity of claim and benefit data sources
  • Alignment of claim history format
  • Integration with adjudication system
  • Linkage or import of plan data (GxCare™ recommended)
  • Linkage or import of eligibility data (optional)
  • Hosted option available
Claim Selection – Key Features
  • Selection summary
  • Claims by member
  • Claims by drug or category
  • Claims by client or group
  • Formulary coverage
Claim Analysis – Key Features
  • Paid/reject analysis
  • Reject frequency
  • Pricing analysis
  • Claims by defect tag
  • Threshold analysis