Seamlessly integrate these apps within your PLEXIS enterprise core administration and processing platforms for remarkably efficient intelligent automation of your business practices as well as real-time business activity monitoring.
Automate workflows with the industry’s best app for BAM: PLEXIS Alerts™
PLEXIS delivers business activity monitoring (BAM) like never before. PLEXIS Alerts is an advanced app for flexible, intelligent BAM that sends customizable, automatic notifications to a wide variety of devices, including mobile devices. Ready-to-use events and automatic email management are easy to set up with the PLEXIS Alerts Wizard. Advanced functionality is included with configurable, automatic standard and exception reporting and other advanced features for all ODBC-compliant sources.
Learn more about of the benefits and features of PLEXIS Alerts:™
Managed Care Online recently reported that according to a recent employee survey¹ regarding management of their health, 65% of those surveyed want their health plan to send them reminders about critical health actions such as prescription refills and annual health exams. PLEXIS Alerts enables health plans and TPAs to set up “events” associated with data in PLEXIS software to schedule and send such reminders – via email, text, or other communication methods. These alerts help improve overall population health and help minimize the risk of chronic illnesses—and by extension, large dollar claims down the road.
PLEXIS Alerts includes cross-application analysis, alerts, and responses. Its wizard has a simple interface that easily configures appropriate events. Standard features and benefits:
- Email monitoring can be set up to automatically ensure that valuable data is identified, captured, and acted upon in a timely manner.
- Healthcare payers can be instantly notified of important issues such as an impending change in customer status, past due accounts, or claims billed over a predetermined amount.
- PLEXIS Alerts can automatically deliver a letter notifying members of an important update such as a change of benefits.
Powerful extended functionality
One of the most powerful tools within the PLEXIS Alerts app is the IT-workflow configuration. This tool has the capacity to call/trigger another computer program or code to automatically execute additional functions. This “Advanced Event Design” feature enables technicians to extend functionality for sophisticated, site-specific requirements. Mission-critical IT functions are automatically monitored with corresponding alerts.
Plays well with others
PLEXIS Alerts can notify a configurable variety of media devices such as a cell phone, pager, PDA, email or fax recipient(s), an FTP, or a web portal. Reports are delivered in a variety of available formats including HTML, PDF, Excel, Word, and Crystal Reports. Various reporting options include the Microsoft MBS suite, Sage Software products, and many others.
¹Survey conducted by HealthMine
Harness the power of automation when readjudicating and reprocessing batches of claims with PLEXIS ReClaim™
The PLEXIS ReClaim tool can find pended claims and lines and automatically re-adjudicate them; find closed claim lines, negate them or optionally add copies of the original lines and adjudicate the new lines. With over two decades of market experience, PLEXIS understands payers’ needs for a readjudication tool that is easy to deploy yet includes the advanced functionalities to cover every aspect of batch readjudication and reprocessing.
With advanced configurability, PLEXIS ReClaim delivers the following business values:
- Increase adjudication efficiency by minimizing manual intervention
- Streamline workflows for claim reprocessing projects
- Reduce technical requests to your IT group with our batch-friendly search tool
- Deliver better data quality with faster response times
Leverage IntelliRPA® robotic process automation to process healthcare claims more efficiently. SymKey processes claims 6-8x faster than an examiner, with 100% accuracy.
SymKey allows your staff to focus on more complex tasks. Since it runs entirely through the front-end of your claims system just like any user would, your IT department can rest assured that everything is secure and there’s no direct writing to the database tables.
- Faster – For one client, SymKey completed in two weeks what they estimated would take 142 days
- Accurately – SymKey consistently applies business rules and ensures complete and thorough documentation on the claim
- Cost Effectively – SymKey is an afoordable solution that delivers an immediate ROI by increasing auto-adjudication and reducing manual work