Medical and Pharmacy Benefits Management Application


GxClaims™ is a demographic and clinical selection, benefit plan certification, claim adjudication analysis and integrated defect tracking process designed to validate claims processing behavior and increase efficiency in identifying root cause for unexpected claims adjudication outcomes.

%

end-to-end audit ready traceability

%

reduction of time to identify and prepare test claims

%

increase in efficiency in identifying root cause for unexpected claim outcomes

Globally Implemented at Fortune 20 Organizations

  • Spans medical and pharmacy benefits: solves for the combination scenarios and which historical claims will help certify
  • UI driven, does not require coding, scripting of queries
  • Bi-directional traceability of intent all the way to implementation and adjudication performance
  • Comprehensive QA to support high volume
  • Pattern match engine for claims adjudication behavior
  • Predictability of pricing performance
  • Predictability of payout performance
  • Complete codebase for RxClaim and variants, and those of other top PBMs
  • Documentation: Process handbook, training material, marketing collateral, engagement and deployment model
  • Pattern library
Gx Podcast 03: Data Security in Testing, Migration and Systems Consolidation Chief Automation Officer and EVP, Dheeraj Misra, and Senior Vice President of Delivery, Donna Posnack-Haber, discuss challenges in the fintech world, data centers and more. READ MORE
Gx Podcast 02: The Changing Landscape of the PBM Industry GalaxE's Chief Automation Officer and EVP, Dheeraj Misra, and VP Business of Development, Tore Carlson, discuss mergers and acquisitions, pairing up of health plans and PBMs and more. READ MORE
GalaxE Product Suite Welcome to the GalaxE A brief introduction to our services and Gx products. Our offerings give the insight you need to recognize, prepare and deploy your data and transform your business for competitive advantage in the future. READ MORE
Finance How End-to-End Management Can Benefit Your Business Managing benefit plans is time-consuming and subject to human error, which can affect performance and regulatory compliance. A firm alignment between business and IT leads to efficient benefits plan management. READ MORE
Digital Data The Future of Artificial Intelligence (AI) A look at what Artificial Intelligence might be in 2025 READ MORE
GxClaims Diagram Work smarter with an integrated benefits management system Managing benefit plans is time-consuming and subject to human error, which can affect performance and regulatory compliance. A firm alignment between business and IT leads to efficient benefits plan management. READ MORE
Gx General Overview Gx General Overview Our business-enabling transformations impact people, communities and industries throughout the U.S. and around the world. As a recognized technology innovator with Fortune 500 companies, GalaxE is responsible for the growth and success of many industries. READ MORE
GxClaims - Benefit Load Certification, Claims Generation and Claims Testing GxClaims™ Brochure GxClaims™ is a demographic and clinical selection, benefit plan certification, claim adjudication analysis, and integrated defect tracking process designed to validate claims processing behavior and increase efficiency in identifying root cause for unexpected claims adjudication outcomes. READ MORE
GxCare - Medical and Pharmacy Benefits Management GxCare™ Brochure GxCare™ is an automated benefits plan management system for benefit intake, modeling, and cataloging that provides clients simplified benefits access for easier benefits maintenance and complete traceability. READ MORE
GalaxE Next Generation Brings New Technology Next Generation Brings New Technology Take a closer look at a few key important trends in the industry such as AI and Machine Learning, QA Automation, CI/CD, DevOps, and Blockchain Integration, and how these trends are steadily driving us toward a shared goal – faster and more transparent business. READ MORE
GalaxE Product Suite Welcome to the GalaxE A brief introduction to our services and Gx products. Our offerings give the insight you need to recognize, prepare and deploy your data and transform your business for competitive advantage in the future. READ MORE
Finance How End-to-End Management Can Benefit Your Business Managing benefit plans is time-consuming and subject to human error, which can affect performance and regulatory compliance. A firm alignment between business and IT leads to efficient benefits plan management. READ MORE
GxClaims Diagram Work smarter with an integrated benefits management system Managing benefit plans is time-consuming and subject to human error, which can affect performance and regulatory compliance. A firm alignment between business and IT leads to efficient benefits plan management. READ MORE

Simplified Defect and Test Processing