Partnership will provide a complete, cost-effective out of area network claims processing solution
Ashland, Oregon - August 6, 2003 - Plexis Healthcare Systems and A&G Healthcare Services announced recently they have formed a strategic alliance that will provide their mutual clients with a cost-effective, out of network claims processing solution. Employees covered by managed care programs seek treatment outside of their managed care networks over 30 percent of the time. This partnership will offer a cost-saving solution for employees, employers and other managed care providers. The Plexis number one ranked Claims Manager software will provide accurate, auto-adjudication of the claims, while A&G Healthcare's I-TREX software will provide re-pricing of the claims and significant cost savings to clients.
Plexis Healthcare Systems has lowered administrative costs for its clients by 12 to 16 percent. In addition, the Plexis suite of products offers payers, benefit administrators and health plans the functionality to facilitate accurate and automatic claims adjudication, referral authorizations, benefit administration, and contract management. The Plexis Claims Manager has raised clients' auto-adjudication rates to over 90 percent.
A&G Healthcare Services is a national leader in providing cost containment strategies. The company recently made significant investments in its IT infrastructure, allowing state-of-the-art processing for electronic claims Their PPO re-pricing services are marketed under the brand name of I-TREX (Integrated Transaction Re-pricing Exchange). Re-pricing and electronic processing of primary and secondary PPO claims provide clients with many workflow efficiencies and significant dollar savings.
"We concluded several years ago that technology was the key to unraveling the enigma of health insurance claims processing," said Norman Payson, Chairman, Founder and CEO of A&G Healthcare Services. "A&G's heavy investment in IT infrastructure has allowed us to enter this union of electronic adjudication and PPO claims re-pricing. Our mutual clients can now take advantage of front-end discounts, scanning and imaging (OCR), Plexis superior auto-adjudication, and our mailroom functionality. This partnership has truly created a complete solution," Mr. Payson added.
Plexis Healthcare Systems' CEO and President, Jorge Yant said, "This alliance provides a win-win solution for any managed care provider who must deal with out of area network claims. A&G Healthcare has the industry's best software for re-pricing and obtaining discounts on healthcare claims. Out of area network claims are a growing portion of healthcare claims and this partnership provides a cost-effective, end-to-end solution for handling them."
"We have seen several companies attempt to craft a strategy for this problem, but they have all been unsuccessful because they lacked the integration capabilities and did not have the technology pieces to complete the solution. Plexis and A&G Healthcare are the first companies to have all the IT pieces needed for a complete out of area network claims processing solution," said Kent McRee, Senior Vice President of Business Development at A&G Healthcare Services.
About A&G Healthcare Services
A&G Healthcare Services, headquartered in Plano, TX, is a medical cost containment company serving more than 600 payor organizations by providing re-pricing and fee negotiation services for claims that have been determined to be out-of-area or network. A&G also owns and operates a national travel wrap PPO network named Amera-Net which provides superior coverage for payor clientele members. A&G provides its clients with a complete suite of services that include membership ID card fulfillment to insure proper steerage with logos placed on each individual membership card. A&G has served the healthcare payor market for over eight years. For more information, please call (972) 312-8589 or visit www.aghealth123.com.
Plexis Healthcare Systems
Press Contact:
David Goodwin
voice: 541-494-2549