Plexis Reinsurance Solutions

Improved management of reinsurance claims can result in significant profits, while undetected reinsurance recoverables can result in lost revenue. For many organizations, reinsurance administration is the key to optimizing profitability.

Healthcare reinsurance protects against losses related to certain conditions, specific diseases, or over a certain magnitude. Plexis provides the tools to report and track stop-loss insurance claims, re-price policies and analyze the data allowing you to manage your bottom-line and improve profitability.

Managing Stop-Loss Reinsurance

The Plexis solution manages stop-loss reinsurance by collecting health claim data to identify enrollees and conditions that meet stop-loss reinsurance criteria. If a patient's condition reaches the threshold of these criteria, the claim is reported and re-priced according to the reinsurance policy.

The Plexis claims management system provides the data required to identify reinsurance opportunities. The Plexis reinsurance solution eliminates the errors which accompany manual reinsurance processing with rules-based automated processing.

Plexis reporting tools provide analytical capabilities that allow organizations to create modeling scenarios to identify the impact of various deductible levels and risk factors for specific patient conditions.

Plexis provides the flexibility to create unique reinsurance processes. Organizations can define reinsurance arrangements and automated reinsurance processing, including reporting and recoveries. The Plexis claims management system also provides work and document management through tracking incidents for reinsurance processing, generating reinsurance reports, recovery statements, and notifications.

Plexis Reinsurance Features

Plexis Reinsurance Solution automates the administration of reinsurance agreements to improve efficiency, accuracy and profitability.

• Identify previously undiscovered collectibles
• Track and report reinsurance claim detail
• Identify and calculation of cessions
• Integrated with benefits, claims, regulatory, and financial solutions to streamline your administrative process
• Reporting provides analytical data for managing renewals, profitability and optimizing data flow
• Improved service to reinsureds

 Learn More About Plexis Claims Manager