Multi-national Insurers Leverage the PLEXIS Platform for Expansion and Cost Containment

As multi-national insurers seek to optimize their cost control objectives and expand into markets in Asia, MENA, the Caribbean, Latin America, and elsewhere, they need a powerful, flexible payer platform. Covering over 70 million people worldwide, PLEXIS’ integrated clinical, financial, and administrative platform scales to meet the needs of the largest multi-national insurers. The PLEXIS platform uniquely supports opportunities for multi-national insurers with effective risk management, scalable transaction processing, centralized core administration, and optimizations for transparency, compliance, and complex multinational requirements.

PLEXIS empowers multi-national insurers to:

  • Scale to process large transaction volumes: PLEXIS’ proven platform was architected to process the largest transaction volumes in our industry. Extensive EDI capabilities streamline complex international workflows for enterprise-wide efficiencies. Quickly bring on new clients or add new lines of business.
  • Centralize your core administration: PLEXIS integrates coordination for major medical, fully-insured products, disability, life, travel assistance, commission support, premium billing, and more. Network management for multiple reimbursement arrangements allows you to enhance collaboration with providers and members.
  • Meet cost containment objectives: Recover significant savings while reducing utilization by leveraging PLEXIS’ configurable alerts, automatic audits, health risk assessments (HRAs), responsive reporting, and more
  • Optimize transparency, oversight, and accountability: Solutions such as integrated fraud, waste, and abuse (FWA) detection and automated claim editing reduce or eliminate duplication of resources across multiple countries.
  • Meet complex compliance requirements: Accelerate growth while minimizing risk through end-to-end transparency and centralized premium and claim data. PLEXIS provides holistic visibility for compliance requirements including transfer pricing challenges, visibility over premium allocations, and BPO requirements.
  • Process cultural-specific requirements: PLEXIS integrates specific international functionalities such as member-centric customer service, support for multiple languages, multi-currency calculations, real-time adjudication, and portal access for clients, members, and providers.
  • Predict costs: PLEXIS’ quantitative analytics (BI/BA) deliver actionable intelligence to give you a competitive edge in total cost comparison.
  • Offer mobile solutions such as advanced enrollment services, mobile access to ID cards, provider search, and health/news alerts/emergency info.

Replacing legacy systems results in cost savings and enhanced capabilities

PLEXIS has over 14 years of experience implementing our proven payer platform for international customers in over fifteen countries. PLEXIS provides multi-national insurers with agile solutions to modernize and grow in the business of healthcare.

PLEXIS often serves payers who are replacing legacy systems that do not support multi-currency calculations, handle only US claims, and cannot support custom diagnosis and procedure codes. By replacing these legacy systems, payers can reduce or eliminate manual data entry for claims, and greatly expedite claim processing and customer satisfaction. PLEXIS also has the expertise to create electronic import or export routines that use customized or standardized X12 EDI formats, which assist our clients in streamlining their processes, resulting in cost savings and a wide spectrum of added value for the payer’s organization.