Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
Ensure a steady stream of revenue by utilizing a robust platform that accelerates reimbursements through eligibility verification, tracking claims status, conducting audits and appeals, and managing remittances for both government and commercial claims, all integrated into one cohesive system. Take advantage of a sophisticated rules engine that promptly cleanses claims in accordance with the latest CMS and commercial payer regulations, enabling you to rectify any inaccuracies prior to submission. During the claim upload process, confirm eligibility across all payers and identify any flagged issues, allowing for necessary edits before the claims are sent. Reduce the days in accounts receivable by implementing automated workflows for handling audit responses, submitting appeals, and tracking administrative dispute resolutions. Tailor staff workflow assignments based on the specific claim type and required actions. Additionally, automate the submission of secondary claims to prevent timely filing write-offs. Ultimately, enhance your claims revenue through automated workflows that facilitate quicker and more successful audits and appeals, ensuring your organization remains financially healthy. Furthermore, this comprehensive system can adapt to your evolving needs, providing long-term benefits as your operations grow.
Description
PLEXIS offers a comprehensive suite of top-tier applications designed to equip payers with the advanced capabilities required for contemporary core administrative systems. These applications encompass functionalities such as real-time benefit management, adjudication, automated EDI transmission, and self-service customer portals, ensuring that PLEXIS Business Apps meet all your needs. The Passport feature facilitates crucial connections between core administration and claims management systems, PLEXIS business applications, custom applications, and existing internal systems. Its adaptable API layer allows for real-time integration with various portals, automated workflow tools, and business applications, ensuring that connectivity knows no bounds. By employing this centralized, modern core administration and claims management platform, you can enhance workflows effectively. This approach enables the efficient processing of claims while simplifying the complexities associated with benefit administration, resulting in a swift return on investment and the ability to provide exceptional customer service. Ultimately, PLEXIS empowers organizations to thrive in an increasingly complex healthcare landscape.
API Access
Has API
No
API Access
Has API
No
Integrations
Inovalon Provider Cloud
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Pricing Details
No price information available.
Free Trial
Yes
Free Version
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
Yes
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
Yes
In Person
Yes
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
Yes
In Person
Yes
Vendor Details
Company Name
Inovalon
Founded
1998
Country
United States
Website
www.inovalon.com/products/provider-cloud/revenue-cycle-management/all-payer-revenue-cycle-management/
Vendor Details
Company Name
PLEXIS Healthcare Systems
Founded
1996
Country
United States
Website
www.plexishealth.com/platforms/
Product Features
Insurance Claims Management
CRM
No
Claims tracking
No
Customer portal
No
Document management
No
EDI data exchange integrations
No
Electronic claims
No
Fraud management
No
Reporting
No
Product Features
Benefits Administration
COBRA Administration
Yes
Claims Management
Yes
Deduction Management
Yes
Disability Insurance Administration
Yes
Employee Benefits Administration
Yes
FMLA Administration
Yes
FSA Administration
Yes
Flexible Spending Accounts
No
For Brokers
Yes
For Employers
Yes
HIPAA Compliant
Yes
Health Insurance Administration
Yes
Life Insurance Administration
Yes
Online Benefits Enrollment
Yes
Premium Billing
No
Provider Management
Yes
Retiree Administration
No
Retirement Plan Management
No
Claims Processing
Adjustor Management
Yes
Case Management
Yes
Claim Resolution Tracking
Yes
Co-Pay & Deductible Tracking
Yes
Compliance Management
Yes
Customer Management
Yes
Electronic Claims
Yes
Forms Management
Yes
Paper-Based Claims
Yes
Payor Management
Yes
Policy Administration
Yes