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Plexis Partner Program
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3M - www.3m.com 3M is fundamentally a science-based company. We produce thousands of imaginative products, and we're a leader in scores of markets - from health care and highway safety to office products and abrasives and adhesives. Our success begins with our ability to apply our technologies - often in combination - to an endless array of real-world customer needs. Of course, all of this is made possible by the people of 3M and their singular commitment to make life easier and better for people around the world. |
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Accenture - www.accenture.com Accenture is a global management consulting, technology services and outsourcing company. Combining unparalleled experience, comprehensive capabilities across all industries and business functions, and extensive research on the world's most successful companies, Accenture collaborates with clients to help them become high-performance businesses and governments. |
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Altova - www.altova.com Altova® is the creator of XMLSpy® and other leading XML, database, and UML tools. Founded in 1992, Altova is headquartered in Beverly, Massachusetts and Vienna, Austria. A key player in the software tools industry and the leader in XML development tools, Altova is the choice of over 3 million clients worldwide, including 91 percent of the Fortune 500. An innovative, customer-focused company, Altova offers a product line that fulfills a broad spectrum of business needs for development teams in the world’s largest organizations to growing one-person shops. Altova is committed to delivering standards-based, platform-independent solutions that are powerful, affordable, and easy–to-use. |
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Bloodhound, Inc. - www.bloodhoundinc.com Bloodhound is an application service provider specializing in medical claims overpayment protection services. Bloodhound's flagship product, ClaimsGuard, safeguards HMO's, TPAs and other at-risk healthcare payers from overpayment due to duplicate claims and other complexities resulting from processing large volumes of data through traditional claims. |
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CaseTrakker Software - www.casetrakker.com IMA Technologies provides Health Care and Social Service organizations with a comprehensive solution for care management. We understand the intricacies involved in care management and offer a platform to integrate proven business processes across your entire organization. The centralized, secure system offers users the flexibility and scalability to streamline workflow, produce complex reports, and manage costs. CaseTrakker Software has helped improve the delivery of care in small to very large organizations such as Hospitals, Public Health, HMOs, PPOs, TPAs, Worker's Compensation, AIDs Services, Elder Care, Mental Health, and many more. |
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Claimsnet - www.claimsnet.com Claimsnet is a leading provider of Internet-based claim processing solutions for the healthcare payer industry, including distinctive, advanced ASP technology. Headquartered in Dallas, Claimsnet offers systems that are distinguished by ease of use, customer care, security and measurable cost advantages. Claimsnet clients gain access to a broad range of provider organizations for the efficient exchange of HIPAA-defined electronic healthcare transactions. Claimsnet also offers paper conversion services and PPO claims routing along with EDI services. We see the combination of these three services as one of the critical components required to streamline the claims workflow process to allow payers to achieve 100% electronic claims processing. |
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CSC - www.csc.com A Fortune 200 company, CSC is one of the world's largest and most respected providers of information technology services. Since 1959, the organizations that collaborate with them have benefited from every wave of IT innovation. |
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DataWing Software - www.datawingsoftware.com DataWing Software has offered cost-effective solutions for healthcare eligibility verification and reconciliation since 1996. Our products reconcile payer eligibility with your system, verify real-time eligibility, and verify payer cap payments. Our clients say our products are easy to use, and our support is friendly and efficient. |
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Emdeon - www.emdeon.com Emdeon provides technology-based solutions for processing health payers claims communications. Innovative technology and streamlined distribution processes provide our clients with immediate savings by reducing postage, labor and material costs. Emdeon delivers solutions to over 350 clients, ranging from small TPA's to large managed care organizations and insurance carriers, each realizing annual cost savings of $35,000 to $1,500,000. |
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Flex Tech - www.flextech.com FlexTech's quality IT consulting services have been used to streamline operations at managed care organizations nationwide since 1989. Our experienced consultants analyze, develop, manage, convert and implement healthcare's leading software systems and solutions. FlexTech's expertise includes Data Warehousing, HEDIS, EDI, HIPAA Remediation and many other consulting services. |
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Health Portal Solutions - www.HPSGlobal.net WEBWorks is the secure web portal application through which users can view their Plexis claim system data. User levels include the Healthcare Administrator, Employer/HR, Members/Dependents, Agents/Brokers, and Providers. Because of its ability to integrate multiple data sources into one web portal, the WEBWorks application offers a streamlined approach to managing healthcare data and can be used by a variety of organizations including: Managed Care Organizations, Government Entities, TPAs, PPOs, Health Insurers, PHOs, and IPAs. By accessing claim data, medical records, and wellness tools through the WEBWorks web portal, users are empowered to make educated health and financial decisions on their own, which conserves your organization’s time and resources. As the developer of the WEBWorks application, Health Portal Solutions is committed to developing and supporting web portals that improve productivity, increase efficiency, and enhance the operations of your organization. With over 10 years of experience in the healthcare services industry, its web portal technology and support services have helped numerous healthcare organizations grow their brand reputation and their bottom line. |
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Intuit - www.quickbooks.intuit.com After 20 years, Intuit continues to transform business and financial management for small businesses, accounting professionals and consumers. The company's mission is to create new ways to manage personal finances and small businesses that are so profound and simple, customers cannot imagine going back to the old way. |
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Microsoft - www.microsoft.com At Microsoft, we're motivated and inspired every day by how our customers use our software to find creative solutions to business problems, develop breakthrough ideas, and stay connected to what's most important to them. |
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Microsoft - www.microsoft.com/dynamics/gp/ Microsoft Dynamics is an ideal solution for organizations implementing a business management system. The architecture of Microsoft Dynamics allows this application to grow with the organizations using it. |
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MS HHS - www.microsoft.com A solution that integrates the multiple aspects of health insurance delivery—including plan enrollment, privacy, a consumer portal, eligibility determinations, financial services, and program administration—can help you streamline compliance with state health insurance exchange (HIX) provisions. Familiar Microsoft technology can help you deliver a comprehensive, interoperable HIX system that connects new and existing government systems within a consistent architecture. |
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Mitan Technologies - www.mitan.com Mitan serves the health insurance industry by using the Internet to communicate information between providers of health care and third party payers so that transactions can be processed in real-time. Our technology allows for Point of Care Settlement between providers of health care and their patients through a proprietary interface with Plexis' products. |
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Optum - www.optum.com Optum was founded in 1996 to develop, acquire, and integrate the world’s best-in-class health care information technology capabilities. They are a global leader in health information technology and services throughout the healthcare system. |
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PHX - www.phx-online.com PHX delivers advanced cost management solutions for health plans. They combine claim processing automation with professional services to deliver a centralized, integrated approach to cost management, increasing savings in both the near and long term while dramatically reducing errors and turnaround time. All services are handled in-house for maximum privacy and legal regulatory compliance. They also supply full technology implementation, training and support for quick, seamless integration into any organization. |
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VisibilEDI - www.visibiledi.com VisibilEDI Inc. is a cloud based solution provider of an integrated EDI management system for Health Plans, Clearinghouses, Third Party Administrators, and Managed Care Organizations. The VisibilEDI transaction management system helps organizations efficiently manage the flow of information to/from their trading partners and electronic data consumers. The VisibilEDI system can help regulate inbound transactions and be utilized to report information in HIPAA mandated X12 formats to providers, members, and encounter destinations for Medicare & Medicaid contracted plans. |
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World View, LTD. - www.worldviewltd.com WorldView Ltd. provides Enterprise Content Management (ECM) solutions designed to fit the needs of the healthcare payer industry. By utilizing the WorldView solution, organizations maximize enterprise-wide efficiency by eliminating redundant manual tasks and improving day to day processes often associated with claim adjudication, enrollment, and more. With features such as EDI Processing, Document Workflows, Electronic Forms, Document Composition, and the convenience of direct integration capabilities with native healthcare software systems, the WorldView solution is scalable to meet the specific needs of all organizations. |
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Next Steps
Industry Term
Incurred claims divided by premiums