Dental claims processing for payers

PLEXIS provides dental-specific toolsets and the industry’s best practices for dental claims processing and the administration of dental benefits. PLEXIS’ integrated clinical, financial, and administrative platform empowers payers with enterprise-wide cost-savings and a wide range of enhanced efficiencies including cost containment, streamlined benefit plan design, data analysis, reporting, and utilization management.

The PLEXIS platform delivers:

  • Flexible configuration for benefit plan design, benefit administration, and fee schedule management
  • Streamlined electronic enrollment and eligibilities
  • Dental claims auto-adjudication and claim editing including linked claims, authorizations, and rules-based procedure code logic
  • Provider network management with customizable dashboards that enhance transparency, collaboration, and engagement
  • Flexible premium billing capabilities to eliminate manual data entry and improve productivity, accuracy, and billing efficiency
  • Referral and authorization management
  • Comprehensive customer service provides call center operators with quick access to all relevant information
  • Self-service member/provider portals accelerate real-time services and reduce paper workflows

See our solution for dental plans