Online Claims Processing &
Real-time Adjudication

Combining the power and flexibility of Plexis Claims Manager with Plexis Direct allows claims to be adjudicated in about the same time as a credit card transaction.

Speed

Traditional claim adjudication takes up to 60 days or more to receive and settle, even EDI (electronic data interchange) systems take up to 10 days to finalize. Plexis Direct can receive and adjudicate claims in seconds.

Lower Costs

Using Plexis Direct's Fast Class System, claims are auto adjudicated in real time. You will increase employee productivity, enhance process efficiencies, reduce paper documentation, avoid costly timely payment penalties all while improving provider satisfaction.

Flexibility

Plexis Direct requires no investment in special hardware or new software -- all you need is access to the internet.

Here's How It Works

Plexis Direct accepts transactions from healthcare providers, reformats and sequences the data, transmits the transaction to Plexis Claims Manager and returns results in real-time via Internet processing.

Plexis Direct integrates with Plexis Claims Manager to provide immediate results for patient eligibility, claim submission, claim repricing, claim status and most importantly, claim adjudication. Providers submit transactions and receive results immediately by simply utilizing a standard Internet Explorer browser.

Plexis Direct Technology Overview

The Plexis Direct platform is based on Microsoft Windows 2000 Advanced Servers. The system utilizes Microsoft SQL Server 2000, Microsoft .NET and Internet Information Services 5.0 to provide a secure, stable and scalable environment for brokering claim transactions.

Plexis Direct's Fast Class Services are used as the communication vehicle, providing interoperability between disparate information systems. Plexis Direct's Fast Class Architecture was developed using Microsoft .NET Web Services, comprised of Simple Object Access Protocol (SOAP) and XML for the communications protocol.

Plexis integrates advanced security features including SSL Encryption to ensure the protection of all transactions. Extensive message handling capabilities are integrated to provide transactional support, making sure the transaction is delivered and returned intact.