Ashland Oregon (PRWEB) November 13, 2011
Plexis Healthcare Systems, Inc. is pleased to announce the newest release of its Quantum Choice™ product. Version 2011.3 was released on September 30, 2011 and contains many new features to further support the processing capabilities of Plexis’ healthcare payer clients. Version 2011.3 includes additional automation capabilities for claims processing, member management and electronic data interchange (EDI).
Enhancements in claim processing include expanded automation in pricing institutional claims based on several configurable criteria, including a facility’s location (state), a percentage of the Medicare allowable for a DRG or APC reimbursement, and if specific carve-out arrangements are provided. Each of these allows unique agreements with hospitals to be tailored within the Quantum Choice system to drive higher levels of automated pricing. Additionally, procedure modifier processing and configurable duplicate check rules have been greatly expanded, and new global period processing edits have been included.
Several enhancements have also been made to the member services and enrollment components of Quantum Choice, allowing for improved capture of foreign (non U.S.) addresses and greater automation of the enrollment process when rider plans are involved.
Additionally, Plexis is helping its clients address the challenges of testing and implementing the newest HIPAA X12 requirements for use of the 5010 formats. Quantum Choice v. 2011.3 now includes the capability to process (import and export) many of the most commonly used X12 5010 formats, with additional workflow automation specific to the X12 5010 835 remittance advice (export). Processing of electronic files and messages is accomplished via use of Quantum Choice’s service layer (Quantum Data Services), for which many new services have been added since the last release of the product.
“Plexis is proud to be able to include so many useful new features in the most recent release of our Quantum Choice product, which are the result of both market and client driven needs”, said Sean Garrett, Chief Product Strategy Officer of Plexis. “The ability to automate many daily repetitive workflow routines and steadily deliver greater claim adjudication efficiency and automation is paramount to the value Plexis continues to offer commercial and public sector healthcare payer administrators.”
About Plexis Healthcare Systems, Inc.
Plexis Healthcare Systems is a leading payer solution and claims processing technology company based in Ashland, Oregon. Founded in 1996, Plexis software and services now process millions of claims transactions daily for healthcare payer organizations throughout the United States and internationally. 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 healthcare organizations; and MITA 2.0-aligned Plexis Quantum Choice, for government healthcare organizations and large health and dental plans. Plexis' solutions enable government healthcare organizations, health plans, TPAs and provider groups to reduce costs, automate claims payment and medical case management requirements, enhance customer satisfaction and expand market share. For more information, please call toll free (877) 475-3947 or visit http://www.plexisweb.com.
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