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Nexo Access

For health plans & payers

A transportation benefit that holds up to review.

Every trip runs on a credential-gated network, and every claim clears the same checks, so the benefit has one accountable record.

Control ledgerOne trip record
  1. 01AssignmentCredentials current
  2. 02ClaimChecks complete
  3. 03ExceptionHuman review

Operating view

The important controls stay visible in a clear sequence. Product excerpts are labeled as sample data.

01

Credential-gated network

Only current credentials get on the road.

The network checks itself before a trip is assigned.

  • Drivers and vehicles with lapsed credentials are blocked from assignment, checked live at dispatch.
  • Providers only receive the service levels they are formally approved for, enforced at the database level.
  • Every assignment carries the credentials it was cleared against.
02

Claims discipline

The same checks on every claim, every time.

No claim skips a step, and nothing changes after it is frozen.

  • Four automated scrubbing checks before submission.
  • Seven adjudication checks route every claim to approve, review, or deny.
  • Thirteen fields frozen at submission into a tamper-evident record.
  • A database constraint makes double-paying a claim impossible.
03

Program integrity

Exceptions surface before the money moves.

Flagged claims wait for a person; the rest keep moving.

  • Flagged claims are held out of auto-payment for exception review.
  • Pattern reports and CSV / Excel exports support program review.
  • Timely-filing windows warn before they lapse.
Exception reviewSample data
CLM-4471Timely-filing: 5 days left
Held out of auto-payment · flagged for review
CLM-44707/7 checks · auto-approved
Pattern report · export CSV / Excel

Next step

See how it fits your program.

We will walk your team through the controls, reporting, and coordination model.

Talk to us