PLEXIS offers several powerful solutions to integrate and automate the complexities of inpatient/outpatient Medicare prospective pricing for claims. PLEXIS’ business apps, AMP$ and the 3M™ Grouper Plus System, simplify adjudication while saving time and improving accuracy. These solutions cover Medicare codes APC and DRG (and ASC within PCM only).
By leveraging PLEXIS’ prospective pricing apps, healthcare payers centralize and simplify the adjudication process. With access to embedded regulatory content, payers can analyze data and conduct reporting for their clients.
Configurable Medicare grouper and pricer routines
Payers can provide reliable, high-speed processing of healthcare claims by utilizing expert grouping content for denials management and for budgetary and management purposes. Administrators can choose the classification and reimbursement methodologies they need to accurately group, edit, and calculate the expected reimbursement of individual claims.