Ashland, OR – October 11, 2005 – Bienvivir Senior Health Services, one of the nation’s largest PACE organizations, has selected Plexis Claims Manager for their claim processing and benefit administration system, and Plexis EDIWorks to provide their electronic data interchange services. Bienvivir Senior Health Services represents the third major PACE (Program of All-inclusive Care for the Elderly) organization served by Plexis Healthcare Systems.
Based in El Paso, Texas and established in 1987, Bienvivir Senior Health Services provides comprehensive healthcare services to frail elders through community-based services. The majority of enrollees are eligible for both Texas Medicaid and Federal Medicare benefits. Bienvivir has 770 members and includes three day health centers and an Alzheimer’s residential unit.
Prior to selecting Plexis, Bienvivir outsourced their claims processing to an external TPA. Plexis Claims Manager allows Bienvivir to bring their claims processing in-house, gain increased control over claims processing/payment, and increased access to data.
“Plexis Claims Manager gives us the ability to internalize the claims processing in a cost efficient manner,” said Joaquin Garcia, Bienvivir’s Chief Financial Officer. “It will provide us with the capabilities to capture internal and external encounters in one centralized place, to monitor and control cost and to report claims data using a single process. We believe Plexis Claims Manager is user friendly and can be modified to meet our needs in a cost-efficient manner,” said Garcia.
“Bienvivir’s selection of the Plexis system demonstrates our ability to streamline the administration of long term care benefits, reduce administrative costs and improve productivity for PACE organizations. Plexis Claims Manager provides a single repository for complete reporting capability across all claims, participants, providers, lines of business and procedures. The rules-based engine and relational database make it easy to tailor the system to perfectly fit the requirements and goals of healthcare organizations,” said Yant.
Plexis Healthcare Systems
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David Goodwin
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