Process Claims Faster with PLEXIS’ CMS Medicare Advantage Software
Health plans process claims more accurately and efficiently using PLEXIS Healthcare Systems’ CMS Medicare Advantage software. Medicare eligibilities continue to grow, placing burdens on older claims software. The PLEXIS’ CMS Medicare Advantage Software platform accommodates CMS requirements and automates numerous workflows for claims adjudication and core administration. PLEXIS’ integrated financial, clinical, and administrative payer platform positions your organization to meet evolving compliance standards while delivering coordinated, consistent, cost-effective care for all your MA plans.
Paving better payer-provider relationships
Payer-provider partnerships create highly beneficial payment models that drive better care outcomes for patients. Payers and providers rely on the PLEXIS platform’s collaborative tools to provide critical data and communication. Innovative payment models succeed and excel with our data-driven approach to keeping patients healthy and lowering costs.
The PLEXIS platform simplifies Medicare Advantage administration. It allows full connectivity for all the patient-centered big data that provides essential visibility for episodes of care. Then its intelligent dashboards organize the data into actionable intelligence that helps drive better care at lower costs.
PLEXIS’ Medicare Advantage software drives rapid growth
One of PLEXIS’ clients is a third party administrator (TPA) and managed care organization (MCO) that serves commercial, Medicare Advantage, and Medicaid plans. PLEXIS empowers this MCO with auto-adjudication, capitation, and claims processing for annual cost savings of over 1 million dollars. The infographic below depicts the surge in growth this MCO experienced after implementing the PLEXIS platform.
Mission-critical claims processing solutions
PLEXIS’ agile, trusted enterprise platform is the most dynamic claims adjudication and benefit administration software solution on the market. Serving all major healthcare payers for the past 20 years, PLEXIS simplifies and automates claims processing and core administration.
Learn more about our rules-based core administration + claims management solution, our suite of readily-configured business apps, and the cutting-edge healthcare core administration services we offer as part of our full-service MA platform solution.
Serving healthcare payers for over two decades
“It paid off to invest in technology with PLEXIS’ advanced core administrative system,” said Todd Galbraith, Chief Information Officer at Avante Health. “The PLEXIS platform supports our business needs for growth, efficiency, and flexibility.”