Plexis Announces New Claims Editing Capability

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New editing and analytics service offer clients real-time, pre-adjudication claims editing

Plexis Healthcare Systems announced recently they have added a new real-time claims editing capability. The new editing platform, offered through a partnership with Bloodhound Technologies, Inc., helps Plexis' clients contain costs, increase auto-adjudication rates and improve payer-provider relations.

The editing platform can process a single claim or multiple claims simultaneously against full patient history, complete payer policy customizations, and 16 million sourced clinical edits all in 350 milliseconds. Furthermore, the new platform offers pre-adjudication editing that provides healthcare payers significant operational efficiencies, in addition to identifying overpayments.

"We are very pleased to be able to offer these new claims editing capabilities to our clients," explained Jorge Yant, CEO of Plexis Healthcare Systems. "The ability to provide complete customization of edits to exactly match a payer's reimbursement policies will dramatically increase auto-adjudication rates and eliminate the need for pending claims. In addition, this new editing platform is the only one that is fully ICD-10 enabled."

"Bloodhound Technologies designed and built the new platform to align with the larger trends in the market and to constantly evolve with a unique architecture that allows for infinite expansion of the processing capacity," said Gary Twigg, CEO and President of Bloodhound Technologies, Inc. "Open source rules, a full audit trail visible to both payers and providers, and the ability for providers to correct miscoded claims set the standard for provider relations and transparency. Bloodhound believes that this level of visibility will build trust between payers and providers," Mr. Twigg added.

About Bloodhound Technologies, Inc.
Bloodhound Technologies is the only claims editing service and analytics provider to offer a fully transparent, customizable, real time service for all participants in the claims revenue cycle. ConVergence Point, its next generation, hosted claims editing service, can process a claim against 16 million edits across total patient history in sub-second response time. All ConVergence Point edits are open-sourced and based on national standards and can be filtered to exactly match a payer's re-imbursement policies. Further, ConVergence Point provides a Web portal for providers to see edits and correct claims before submission. This remarkable service can integrate with any claims adjudication system, clearinghouse, or claims gateway. Based in Durham, NC, Bloodhound Technologies is a venture-backed company with investments from Noro-Moseley Partners and The Wakefield Group. For more information, visit

About Plexis Healthcare Systems, Inc.
Plexis Healthcare Systems is a leading payer solution and claims processing/benefit administration software company based in Ashland, Oregon. Founded in 1996, Plexis software is utilized in 7 countries by more than 90 companies providing administration for approximately 35 million covered lives. Plexis' family of core software products includes Plexis LCS for small and medium size third party administrators and self-funded groups; Plexis Claims Manager for mid-size, TPAs and managed care healthcare organizations; and Plexis Quantum Choice for middle to large government healthcare organizations, benefit administrators and payers. Plexis' solutions enable government healthcare organizations, health plans, TPAs and provider groups to automate and streamline benefit administration, claims payment and utilization management, enhance customer satisfaction and expand market share. For more information, please call toll free (877) 475-3947 or visit


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