National Health Funds Solve Unique International Challenges with the PLEXIS Payer Platform

PLEXIS has a proven record of success standing up the central technological hub for your country’s national insurance program. Our trusted solutions include end-to-end processing for national health funds from enrollment to member portals and everything in between. Our complete solution empowers your governing body with the scalability and flexibility to implement and be successful in the administration of healthcare.

The PLEXIS platform empowers national health programs to:

  • Centralize and coordinate healthcare for a country: Connect a complex web of healthcare systems and applications under the umbrella of our core administration platform.
  • Enable your citizens to access essential services: PLEXIS deploys self-service portals for real-time adjudication, online enrollment, mobile access to essential services, and end-to-end coverage for your healthcare needs for connection, communication, and collaboration.
  • Scale to meet unique sizes and needs: PLEXIS recognizes the unique cultural needs of a country while assembling the complex package of technological assets that will scale to the size and configuration needed for your country’s healthcare program.
  • Improve the cost and quality of care: PLEXIS’ care management, UM/UR, and disease management gives you the full toolset for data-driven utilization review, Wellness services, and value-based care.
  • Drive healthcare’s financial security: The PLEXIS platform gives you a 360° view of clinical and administrative costs and trends to enable full transparency, accountability, and oversight.
  • Enhance electronic workflows and automated processes: Reduce paper/manual processes and enhance automated efficiencies through powerful EDI workflows.
  • Improve the health of your citizens: PLEXIS’ technological capabilities serve to empower the altruistic goal of managing and improving noncommunicable diseases (NCDs) and population health.

Early identification of critical health issues

PLEXIS has a proven track record in international emerging and evolving healthcare markets. One of PLEXIS’ key considerations for National Health Funds is the ability to accurately analyze and predict healthcare costs associated with an entire population. With powerful, data-driven business analytics, we help you keep costs from spiraling out of control through early identification of outliers and critical health issues. PLEXIS empowers you with configurable alerts; automatic audits and health risk assessments (HRAs); and responsive reporting. When national health programs are informed about the scope of healthcare needs within their populations, they can take more effective action to help improve the health of their citizens.