Automated, cost-effective Contract Health Services software

The Southeast Alaska Regional Health Consortium (SEARHC), a non-profit health consortium comprised of 18 Tribal communities, needed an economical claims administration solution that could be implemented in a short period of time. After utilizing PLEXIS’ platform software, SEARHC reduced claim processing time by 60%. Implementation took less than 60 days. The resulting 35% reduction in costs allowed SEARHC to reallocate more funds for furthering health care initiatives.

Contract Health Services (CHS), now renamed Purchased/Referred Care (PRC), serves a vital role delivering healthcare outside of IHS/Tribal health care facilities. PRC payers require cost-effective, automated software to accelerate claim adjudication and simplify administrative operations. PLEXIS’ core administration + claims management platform software enables PRC payers to reduce costs, meet regulatory standards, leverage federal funding, and grow the business of healthcare while expanding healthcare delivery to tribal members. PLEXIS’ enterprise-level core administrative platform solutions deliver the flexible, agile tools to enable payer success.

Contract Health Services software includes:

  • A rules-based engine to streamline and automate claims processing, benefit administration, enrollments, eligibilities, premium billing, and more
  • Passport connectivity services to provide enterprise-wide interoperability for your entire business ecosystem, across multiple lines of business
  • Progressive, modern technology that delivers scalable results for PRC/CHS payers
  • Best-of-breed business service solutions that help you simplify and automate administrative operations for a quick ROI.

Streamline workflows and achieve your highest business outcomes

PLEXIS’ average client tenure of over 8 years demonstrates our position as a trusted leader in the global healthcare payer community. PLEXIS has established a reputation for cost savings through efficiency, empowering payers to reap a quick ROI from our payer platform solutions. Like SEARHC, client testimonials attest to the unique competitive advantage of implementing PLEXIS’ scalable claims processing solution.

Learn more about PLEXIS’ automated platform solutions, including everything you need for core benefits administration and PRC success.