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PLEXIS Payer Platforms

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(4)3.8/5

Founded in 1996 and headquartered in Oregon, PLEXIS serves healthcare payer administrative organizations serving over 50 million people in all 50 states and 15 countries. PLEXIS provides enterprise core administration processing solutions to healthcare payers, specialty groups (dental, vision, radiology, etc.), TPAs, delegated risk groups (IPAs, ACOs, MSOs), international insurers, and government healthcare organizations/program administrators. PLEXIS Payer Platforms feature highly scalable, highly flexible and extremely automated core systems for the administration and management of health insurance and delegated risk operations, including group and individual policy administration, benefit plan administration, healthcare claims administration and auto-adjudication, provider and network management, payment contracts and fee schedules (both for providers and carriers), authorizations, capitation, premium billing and reporting.

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