Private by design. Intelligent by architecture.
A governed pipeline that operates inside the customer security boundary — from ingest through human approval and audit.
RxNexa is an evidence-first intelligence layer designed to work side by side with PBM informatics teams — private, governed, and explainable.
A private AI-powered PBM intelligence and automation platform — from claims intake through evidence-based recommendations and human approval.
The platform retrieves trusted evidence, validates relationships, reasons across pharmacy data, scores findings, explains proposed actions, and escalates ambiguity rather than guessing.
Every investigation can carry source, effective date, rule, confidence and rationale.
Four coordinated capabilities that turn exceptions into governed, explainable workflows.
Bring together claims, prescriptions, dispensing events, formularies, pricing references and other approved data sources.
Check NDC, NPI, GPI, SCC/340B indicators, pricing, formulary rules and date-sensitive relationships.
Connect related evidence to explain why a claim should be accepted, investigated or escalated.
Ambiguous or conflicting cases become structured informatics workflows instead of unsupported AI guesses.
A governed pipeline that operates inside the customer security boundary — from ingest through human approval and audit.
See how an evidence-first investigation layer can fit your PBM workflow.
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