The Plexis Quantum Choice™ platform supports the following functional needs for State Medicaid (MMIS), SCHIP, Employee Benefit Plans, Medicare Advantage, Workers Compensation Plans and other healthcare programs.

• Benefit Administration
• Claims Processing
• Member Eligibility
• Provider Management
• AR/AP/GL
• COB Processing
• Fee schedule Administration
• Provider/Vendor Payment
• Premium Billing
• Reporting
• Enterprise Administration

Next Generation Configurability In a MITA Aligned Solution

A New Standard of Agility, Flexibility, Rapid Deployment and Cost Savings Takes Your Organization to the Next Generation of Government Healthcare

New Standard for Agility & Cost Efficiency

Plexis’ acclaimed commitment to responsive, flexible engineering has resulted in an innovative new approach to government healthcare administration. Evolving from years of successful experience with the award-winning Plexis Claims Manager - currently processing millions of government healthcare claims at facilities across the U.S. - the new Quantum Choice™ for Comprehensive Government Healthcare Benefit Administration meets today’s challenges and offers a new standard for agility and cost-efficiency in meeting tomorrow’s government healthcare challenges.

COTS-Based, MITA-Aligned to Reduce Costs for Government Healthcare Organizations

Quantum Choice™ offers flexibility, rapid deployment and overall cost efficiency in a COTS-based, MITA aligned, service-oriented architecture (SOA) platform. Designed for use in the public sector, Quantum Choice™ is highly configurable and requires significantly less effort than competing technologies to adapt to policy changes. This configurability is the key to a flexible design that allows government healthcare organizations to streamline automated processes, reduce administrative costs and reposition valuable resources for more profitable operations.

Scalable to Meet Tomorrow’s Government Healthcare Challenges

Government healthcare organizations also require scalability to effectively manage a growing population and new products. Quantum Choice's™ flexible, N-tier architecture supports multiple lines of business on one platform, sharing key data elements and eliminating data silos among various agencies. This platform approach to government benefits administration improves overall cost effectiveness, eliminates the limitations of processing with multiple systems, and allows seamless business processes to drive the needs of multiple lines of business.

The Plexis solution combines interoperability, configurability, and easy integration to successfully reduce setup time and testing and deployment costs, promoting best business practices for each installation’s needs. Powered by a flexible, rules-based processing engine, this MITA 2.0-ready solution adapts to support organizational business processes and allows for seamless integration of administrative and clinical data.

Benefit Plan Building Blocks – Scalable to Support Multiple Programs

Creating and managing unique benefit plans is easy with Quantum Choice's™ flexible building block design. Using open, service-oriented architecture (SOA) to further optimize processing, this software offers immediate revenue opportunities. For example, SOA allows state healthcare organizations to support multiple programs, such as Medicaid, SCHIP (Children’s Health programs) and Public Employees Insurance plans—all under one enterprise-wide solution with unlimited scalability through the deployment of RAIS (Random Array of Inexpensive Servers).

All-in-one Accounting Support with Internal AP/AR System

On-board accounting system allows for user-defined account numbers, creation and maintenance of GL accounts and bank reconciliation. The system supports all programs requiring members to provide various levels of fiduciary responsibility, including co-pays, coinsurance, spend down, etc. System may also be configured to perform tax calculations as AR or AP transactions. Support for EFT and ACH is also included.

Protect Data with Easy-to-mange, Multi-level Security

In today’s highly-competitive market, stolen or lost data is a growing concern, and security is essential at every level of government healthcare administration. Quantum Choice™ makes it easy to manage security at multiple user levels.

Quantum Choice™ optimizes security-protected management of global settings, including code and code group management, patient notes, result codes, and more. These data safeguards provide effective means for enforcing and automating system security, allowing administrators to easily manage data protections at every level. Security settings will also apply to reporting, allowing the creation of a secure/limited report set per workgroup or management group.

Agile Workflow Automation Boosts Efficiency and Cuts Costs

Significantly increase productivity of claims analysis and processing, improve auto-adjudication speed and rates, enhance customer service, billing and payment. Quantum Choice™ provides configurable workflow automation to streamline operations using auto-triggered correspondence and global auto-routing capabilities.