Plexis Claims Manager Benefits Administration & Claim Processing Software

Plexis Claims Manager is an integrated healthcare information system providing complete benefit administration, medical and vision claim processing, and reporting features for organizations in a competitive healthcare IT environment. By providing benefits administration software that is tailored to reduce costs, Plexis Claims Manager helps to improve healthcare delivery and deliver a solid return on technology investments.

Automated Medical, Vision and Dental Claims Processing

Claim processing and auto adjudication is accomplished by entering claim processing data on a single screen. Claims flow seamlessly from their source to final preparation for payment in seconds and at only pennies per claim. Plexis Claims Manager delivers high auto adjudication rates, often with no user intervention.

Integrated Benefit Administration, Claim Processing and Reporting

Plexis Claim Manager's integrated benefit administration, claim processing and reporting functions make it easy to manage health plan data. From premium billing and referral authorizations, to accumulators and custom reports, the Plexis rules-based engine makes it easy to change processes and respond to trends that impact your bottom line.

Flexible Standard and Custom Reporting

Plexis Claims Manager provides powerful automated reporting capabilities that allow you to query any information in your database, extract data with any ODBC-compliant software, and create standard or custom reports on any data in the claim processing or benefit administration process. Plexis Claim Manager's reporting features allow organizations to forecast benefit changes, identify healthcare billing trends and new cost-saving opportunities with hard data.

Broad Scalability to Grow with Your Business

Plexis Claims Manager is capable of administering unlimited benefit plans, provider contracts, and members - there's no need for additional systems as your business expands.

HIPAA Ready

Plexis Claims Manager is certified HIPAA-ready by Claredi to ensure regulatory compliance.

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Plexis Add-on Component Software

Plexis healthcare software components seamlessly integrate with Plexis Claims Manager and Quantum Choice to expand functionality.

Plexis Analytics Plexis Analytics is a complete application that streamlines the performance management of healthcare payer organizations with planning, budgeting, forecasting, reporting and analysis.
Related Links:	Plexis Analytics Home Page Download the Analytics Product Brief
Plexis Direct Plexis Direct is a compact, web-delivered desktop application that is capable of importing claim data from any practice management system. This enables users to easily validate, edit, manage, and track claims from submission to payment.
Related Links:	Plexis Direct Home Page Download the Direct Product Brief
Plexis EDIWorks Healthcare EDI interface supports major HIPAA formats and includes a rules engine and XML-based API for implementing proprietary import and export routines.
Related Links:	Plexis EDIWorks Home Page Download the EDIWorks Product Brief
Plexis WEBWorks Advanced Web front end that supports consumer-directed health plans (CDHPs), health savings accounts, disease management, and other emerging programs. In addition, WEBWorks offers predictive modeling and analytic tools to help your business grow.
Related Links:	Plexis WEBWorks Home Page Download the WEBWorks Product Brief