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. Administrative costs drop when premium billing, capitation, commissions and claim adjudication become automated. This automation frees staff to make informed decisions based on documented trends and actual expenses. Plexis health plan administration software includes standard and ad-hoc reporting capabilities that provide decision-making information for every area of health plan management.

Plexis claims systems provide health plan administrators plan with reports that not only summarize who's making the claims, but also compare provider costs and enumerate the services members are choosing on a regular basis. From managing member enrollment and providing instant feedback to call centers to adjudicating claims in seconds and administering contracts in key strokes, health insurance companies will accomplish more work in less time with Plexis benefits administration software.

Plexis benefit administration and claim processing software provide flexibility enabling users to re-configure the system as market, product or regulation changes develop. As new insurance products - such as consumer-directed healthcare (CDHC) plans - emerge in the marketplace, Plexis rules-based processing engine makes it easy to change business rules without hiring a team of programmers.

Health insurance claim processing also benefits from Plexis EDIWorks™. EDIWorks™ (electronic data interchange software) eliminates a great deal of paper-based processing and improves claim processing efficiency by integrating claims adjudication data from providers directly into the Plexis database. The EDIWorks™ XML Translator allows heath plan administrators to apply their own business rules to the electronic data, resulting in a constant stream of information into the database.

Plexis WEBWorks™ is user-configurable healthcare web portal software that significantly reduces health plan claims processing costs associated with call center operations. Plexis WEBWorks™ allows providers to check members' eligibility status online and provides a full-service healthcare web portal that allows consumers to check claim status, research provider network information, enroll on-line, and review health links that can educate consumers about medical issues and improve their well-being.