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What is PLEXIS Payer Platforms?

PLEXIS provides an extensive array of high-quality applications tailored to equip payers with the sophisticated functions necessary for modern core administrative systems. These applications feature capabilities such as real-time benefit management, adjudication, automated EDI transmission, and self-service customer portals, ensuring that PLEXIS Business Apps can fulfill all your requirements. The Passport feature is essential for establishing vital connections between core administration and claims management systems, PLEXIS business applications, custom software, and existing internal systems. Its versatile API layer permits real-time integration with a variety of portals, automated workflow tools, and business applications, guaranteeing limitless connectivity. By utilizing this centralized and contemporary core administration and claims management platform, organizations can significantly enhance their workflows. This strategy not only streamlines the processing of claims but also alleviates the challenges tied to benefit administration, leading to a quick return on investment and the capacity to deliver outstanding customer service. Ultimately, PLEXIS enables organizations to excel in a healthcare environment that is becoming progressively intricate, ensuring they remain competitive and responsive to client needs.

What is Evolent Health?

Evolent Care Partners, a healthcare provider based in the Midwest, has achieved notable progress in both clinical and administrative performance, securing the impressive position of third nationally for total shared savings and the percentage of savings relative to benchmarks. By equipping independent primary care physicians with vital resources and capital, Evolent Care Partners enables them to successfully navigate and flourish under two-sided payer contracts, thus reducing their financial risks. In the realm of oncology and cardiology, New Century Health improves cost-effectiveness and care quality by utilizing clinical evidence to guide treatment decisions, an approach that garners support from both payers and providers. Additionally, Evolent Health Services enhances the efficiency of health plan operations with a comprehensive suite of services built on a modern, integrated platform and a commitment to strategic partnership. The organization also promotes the exploration of insights and updates related to value-based care, population health, and health plan management, reflecting its dedication to healthcare transformation. Overall, through these collective efforts, Evolent aspires to create a more streamlined and effective healthcare environment for all stakeholders involved.

Media

Media

Integrations Supported

Integrations Supported

OpenPM

API Availability

API Availability

Pricing Information

Pricing not provided
Free Trial Offered?

Pricing Information

Pricing not provided

Supported Platforms

SaaS
Windows

Supported Platforms

SaaS

Customer Service / Support

Standard Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Online Training
On-Site Training

Company Facts

Organization Name

PLEXIS Healthcare Systems

Date Founded

1996

Company Location

United States

Company Website

www.plexishealth.com/platforms/

Company Facts

Organization Name

Evolent Health

Date Founded

2002

Company Location

United States

Company Website

www.evolenthealth.com

Categories and Features

Benefits Administration

COBRA Administration
Claims Management
Deduction Management
Disability Insurance Administration
Employee Benefits Administration
FMLA Administration
FSA Administration
For Brokers
For Employers
HIPAA Compliant
Health Insurance Administration
Life Insurance Administration
Online Benefits Enrollment
Provider Management

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Categories and Features

Benefits Administration

COBRA Administration
Claims Management
Deduction Management
Disability Insurance Administration
FSA Administration
HIPAA Compliant
Health Insurance Administration
Life Insurance Administration
Online Benefits Enrollment
Provider Management

Claims Processing

Claim Resolution Tracking
Co-Pay & Deductible Tracking
Customer Management
Electronic Claims
Paper-Based Claims
Payor Management
Policy Administration

Value-Based Care

Not specified

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