PLEXIS Enables In-house Medicaid Processing

August 2009: A growing Midwest-based regional Health Plan has selected PLEXIS PCM to facilitate automated internal administration for their Medicaid processing. Considering rising TPA costs and previous success with PLEXIS PCM administering a separate line of business, the Health Plan concluded that moving their primary Medicaid business to the PCM platform would streamline processes, reduce costs, increase accuracy and achieve their target ROI.

About PLEXIS Claims Manager (PCM) and Medicaid Processing

Empower the business of healthcare with the proven performance of PLEXIS’ trusted core administration and claims management engine

Built on world-class architecture, PLEXIS Claims Manager (PCM) is flexible, connected, and scalable, delivering automated functionality and streamlined efficiency throughout your business ecosystem. PCM provides complete benefit administration, claim processing, premium billing, capitation, authorization, reporting features, and more.

As one of PLEXIS’ keystone, trusted core administration and claims management engines, PCM drives higher rates of auto-adjudication, empowering the business of healthcare and igniting growth and innovation across multiple lines of business.

Fast, automated healthcare claims processing

PCM empowers domestic and international payer success through the solid technological foundation of our SQL-based platform. With batch or real-time processing, PCM is easy to configure, agile enough to address demanding business requirements, and flexible enough to capitalize on new growth opportunities. With a familiar Microsoft Windows screen format, PCM requires minimal training time and can be seamlessly integrated into your current technology ecosystem.

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