PACE benefits include, but aren’t limited to, all Medicaid and Medicare covered services. PLEXIS enterprise core administrative platforms enable greater interoperability with advanced EDI technology.
Medford, Oregon – May, 2022 PLEXIS Healthcare Systems, a leading healthcare payer
technology company and innovator in next generation digital core administrative processing
solutions (CAPS), today announced another payer administrator selecting PLEXIS Claims
Manager (PCM) to meet the needs of a growing membership within the CMS program known as
the “Program of All-Inclusive Care for the Elderly” or PACE.
One of the key reasons for selection was PCM’s real time and batch integration (API/web
services, x12 EDI) technology that assists health plans/insurers, TPA’s, delegated entities, and
other payers in achieving digital transformation of their enterprise.
Gartner, a technological research and consulting firm, affirms the industry-wide need for payers
to evolve to the “All-Digital” paradigm by defining the Digital Healthcare Payer Platform. “The
Digital Healthcare Payer Platform (DHPP) is an architectural approach that enables payers to
adapt their business and operating models in response to external disruption and changes in
business strategy.”
“Constant regulatory and market disruptors within the payer industry are driving an ever-
increasing adoption of scalable, flexible, and interoperable core administrative platforms to
deliver health value within the dynamic future of healthcare.” said Sean Garrett, chief operating
officer for PLEXIS Healthcare Systems. “It is incumbent upon leading edge payer technology
providers, like PLEXIS, to provide a path of least resistance towards digital transformation and
acceleration into the future of digital healthcare.”
About PLEXIS Healthcare Systems
Celebrating 25 years of service, PLEXIS Healthcare Systems is a leading payer technology company that delivers trusted enterprise core administration and claims management solutions to healthcare payers and delivery systems around the globe. More than 100 organizations trust PLEXIS core administrative enterprise solutions to manage over 55 million lives in all 50 states and around the globe. PLEXIS provides mission-critical solutions that catalyze efficiencies and connect evolving business ecosystems to a wide range of payer organizations. PLEXIS Healthcare Systems is featured in Gartner’s 2022 Market Guide for U.S. Healthcare Payers’ Core Administrative Processing Solutions (February 2022) as a Representative Vendor.