Plexis Claims Manager

Our delivery Partner, Plexis Healthcare Systems has one of the most reputed claims management systems in the industry. In fact, Plexis’ award-winning benefits administration and claims processing software is exceptionally well accepted by all market players within the Healthcare insurance sector.

Plexis Healthcare Systems' software employs flexible, rules-based engines for every payer organization. Combining flexibility, scalability, powerful reporting and workflow tools, this software provides tools which are critical to the effective and efficient processing of claims for Healthcare payers. The three core platforms highlighted below incorporate complete benefits administration, premium billing, capitation, managed care and claims management.

Some of the common benefits associated with Plexis Technology are as follows:
  • Enables “customization” via standard configuration
  • Service-oriented architecture (SOA) with an enterprise service bus (ESB) focused on being:
  • Incredibly reliable
  • High performance & scalable
  • Unbreakable – services are version agnostic – updates will not cause failures
Plexis Healthcare solutions serve various industry segments. The important ones are:
  • Government: Plexis Healthcare System’s unique Quantum Choice and LCS has the potential of bringing commercial success to Government Healthcare Programs within State, Federal and IHS program space.
  • Health Insurance Companies: Plexis benefit administration software provides health insurance companies with a claims system that reduces costs by focusing on health plan results instead of health plan claims processing.
  • Managed Care Organizations: Plexis offers powerful managed care software packages that provide managed care organizations (MCOs) with technology tools to streamline business processes and increase revenues.
  • Third Party Administrators (TPA): Plexis claims processing and benefit administration software helps Third Party Administrators (TPAs) reduce their workload and costs and add value to their client services. With our software, users can manage member enrollment, provide instant and accurate information to call centers, generate flexible reports, adjudicate claims in seconds, and administer contracts in a few keystrokes.

Apart from the above mentioned broad industry segments, Plexis has also helped Dental Claims Processing, International Healthcare, Reinsurance and PPO, PHO & IPA in cutting down their recurring cost and the smoothening the overall claims processing.

 

425 Washington Blvd., Jersey City,
New Jersey 07302, USA

Phone: +1 201.258.4704 / 201.258.4704
Fax: +1 201.604.3480