Welcome!

News Feed Item

Plexis Healthcare Systems and Context 4 Healthcare, Inc. Announce Expanded Partnership for FirstPass(TM) Real Time Claim Editing Solution

Partnership to Provide Plexis Quantum Choice(TM) Clients With Fully Integrated Claim Editing With Context 4 Healthcare's FirstPass System

NAPERVILLE, IL and ASHLAND, OR -- (Marketwired) -- 03/04/14 -- Context 4 Healthcare, Inc., a leading provider of software solutions for challenges related to detection of fraud, waste and abuse in the healthcare industry, and Plexis Healthcare Systems, a leading provider of enterprise-class, state-of-the-art healthcare benefits administration software, today announced a partnership that will enable Plexis clients using the Quantum Choice™ healthcare benefit management technology to easily implement the Context FirstPass™ claims editing solution in order to streamline their adjudication process while increasing claims auto-adjudication rates.

The integration of Context's FirstPass™ real-time claim editing solution with the Plexis Quantum Choice™ software provides customers with the seamless use of Next Generation technology from two leaders in their fields. During the adjudication process, FirstPass™ utilizes real time editing, firing rules containing millions of code combinations to identify professional and facility claims that are non-compliant, inaccurate, or require investigation for fraud, waste or abuse (FWA) before they are paid and populate downstream applications. The pre-payment detection of potential FWA situations is key to effective management of the health plan's costs and provides a clear alternative to the traditional FWA "pay and chase" administration model. Within Quantum Choice™, customers will be able to take immediate action upon claim issues found by FirstPass, making corrections that increase payment accuracy.

"Plexis had reviewed the capabilities of many claim editing solutions on the market today when determining which one would make the most sense to meet our clients and target markets' particular needs. To start, the product/service had to be able to work effectively in real time as an extension of Quantum Choice's™ auto-adjudication process; as well, the chosen vendor had to have flexible pricing offerings for our diverse client base. We found the FirstPass™ solution from Context to be the one that provided the most value for our particular needs, and given that Plexis had an existing relationship with Context (for use of its UCR data for pricing claims), it made sense to expand that relationship with FirstPass," said Sean Garrett, COO of Plexis.

Mark Earles, President and CEO of Context, notes, "We're excited to be working with an advanced technology partner such as Plexis. Introducing FirstPass™ into Quantum Choice™ for real time editing will allow our mutual customers to realize immediate savings through increased claims payment accuracy and advanced fraud, waste and abuse detection, all the while reducing overall administrative cost."

About Context 4 Healthcare, Inc.
Headquartered in Naperville IL, Context 4 Healthcare develops software and data solutions to solve complex medical claim coding, editing and fraud related abuses. For over 20 years, Context's software and data solutions have enabled healthcare organizations to reduce claim errors, denials and claim-handling costs. Context's customers include insurance carriers, third party administrators, managed care organizations, hospitals, and physician practices. Learn more at http://www.context4healthcare.com/. For additional information please contact David Terry at 630-321-2976 or [email protected].


About Plexis Healthcare Systems
Plexis Healthcare Systems is a leading payer solution and claims processing technology company based in Ashland, OR. 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, self-funded groups and self-governed tribes; Plexis Claims Manager for mid-size domestic and international healthcare organizations; and MITA 3.0-aligned Plexis Quantum Choice, for government healthcare organizations and health and dental plans. Plexis' solutions enable government healthcare organizations, health plans, TPAs and provider groups to reduce costs, automate claims processing and payment routines, enhance customer satisfaction and help expand market share. For more information, please call toll free (877) 475-3947 or visit www.plexisweb.com.

Add to Digg Bookmark with del.icio.us Add to Newsvine

Contact:

David Terry
Context 4 Healthcare, Inc.
630-321-2976
Email Contact

Jay Hammond
Plexis Healthcare Systems
541-494-2506
Email Contact

More Stories By Marketwired .

Copyright © 2009 Marketwired. All rights reserved. All the news releases provided by Marketwired are copyrighted. Any forms of copying other than an individual user's personal reference without express written permission is prohibited. Further distribution of these materials is strictly forbidden, including but not limited to, posting, emailing, faxing, archiving in a public database, redistributing via a computer network or in a printed form.

Latest Stories
In his General Session at 17th Cloud Expo, Bruce Swann, Senior Product Marketing Manager for Adobe Campaign, explored the key ingredients of cross-channel marketing in a digital world. Learn how the Adobe Marketing Cloud can help marketers embrace opportunities for personalized, relevant and real-time customer engagement across offline (direct mail, point of sale, call center) and digital (email, website, SMS, mobile apps, social networks, connected objects).
For organizations that have amassed large sums of software complexity, taking a microservices approach is the first step toward DevOps and continuous improvement / development. Integrating system-level analysis with microservices makes it easier to change and add functionality to applications at any time without the increase of risk. Before you start big transformation projects or a cloud migration, make sure these changes won’t take down your entire organization.
"My role is working with customers, helping them go through this digital transformation. I spend a lot of time talking to banks, big industries, manufacturers working through how they are integrating and transforming their IT platforms and moving them forward," explained William Morrish, General Manager Product Sales at Interoute, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.
With the introduction of IoT and Smart Living in every aspect of our lives, one question has become relevant: What are the security implications? To answer this, first we have to look and explore the security models of the technologies that IoT is founded upon. In his session at @ThingsExpo, Nevi Kaja, a Research Engineer at Ford Motor Company, will discuss some of the security challenges of the IoT infrastructure and relate how these aspects impact Smart Living. The material will be delivered i...
SYS-CON Events announced today that Ocean9will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Ocean9 provides cloud services for Backup, Disaster Recovery (DRaaS) and instant Innovation, and redefines enterprise infrastructure with its cloud native subscription offerings for mission critical SAP workloads.
Your homes and cars can be automated and self-serviced. Why can't your storage? From simply asking questions to analyze and troubleshoot your infrastructure, to provisioning storage with snapshots, recovery and replication, your wildest sci-fi dream has come true. In his session at @DevOpsSummit at 20th Cloud Expo, Dan Florea, Director of Product Management at Tintri, will provide a ChatOps demo where you can talk to your storage and manage it from anywhere, through Slack and similar services ...
Imagine having the ability to leverage all of your current technology and to be able to compose it into one resource pool. Now imagine, as your business grows, not having to deploy a complete new appliance to scale your infrastructure. Also imagine a true multi-cloud capability that allows live migration without any modification between cloud environments regardless of whether that cloud is your private cloud or your public AWS, Azure or Google instance. Now think of a world that is not locked i...
SYS-CON Events announced today that Auditwerx will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Auditwerx specializes in SOC 1, SOC 2, and SOC 3 attestation services throughout the U.S. and Canada. As a division of Carr, Riggs & Ingram (CRI), one of the top 20 largest CPA firms nationally, you can expect the resources, skills, and experience of a much larger firm combined with the accessibility and atten...
In his session at @ThingsExpo, Eric Lachapelle, CEO of the Professional Evaluation and Certification Board (PECB), will provide an overview of various initiatives to certifiy the security of connected devices and future trends in ensuring public trust of IoT. Eric Lachapelle is the Chief Executive Officer of the Professional Evaluation and Certification Board (PECB), an international certification body. His role is to help companies and individuals to achieve professional, accredited and worldw...
MongoDB Atlas leverages VPC peering for AWS, a service that allows multiple VPC networks to interact. This includes VPCs that belong to other AWS account holders. By performing cross account VPC peering, users ensure networks that host and communicate their data are secure. In his session at 20th Cloud Expo, Jay Gordon, a Developer Advocate at MongoDB, will explain how to properly architect your VPC using existing AWS tools and then peer with your MongoDB Atlas cluster. He'll discuss the secur...
DevOps is often described as a combination of technology and culture. Without both, DevOps isn't complete. However, applying the culture to outdated technology is a recipe for disaster; as response times grow and connections between teams are delayed by technology, the culture will die. A Nutanix Enterprise Cloud has many benefits that provide the needed base for a true DevOps paradigm. In his Day 3 Keynote at 20th Cloud Expo, Chris Brown, a Solutions Marketing Manager at Nutanix, will explore t...
In his session at Cloud Expo, Alan Winters, an entertainment executive/TV producer turned serial entrepreneur, will present a success story of an entrepreneur who has both suffered through and benefited from offshore development across multiple businesses: The smart choice, or how to select the right offshore development partner Warning signs, or how to minimize chances of making the wrong choice Collaboration, or how to establish the most effective work processes Budget control, or how to m...
Deep learning has been very successful in social sciences and specially areas where there is a lot of data. Trading is another field that can be viewed as social science with a lot of data. With the advent of Deep Learning and Big Data technologies for efficient computation, we are finally able to use the same methods in investment management as we would in face recognition or in making chat-bots. In his session at 20th Cloud Expo, Gaurav Chakravorty, co-founder and Head of Strategy Development ...
SYS-CON Events announced today that Linux Academy, the foremost online Linux and cloud training platform and community, will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Linux Academy was founded on the belief that providing high-quality, in-depth training should be available at an affordable price. Industry leaders in quality training, provided services, and student certification passes, its goal is to c...
"delaPlex is a software development company. We do team-based outsourcing development," explained Mark Rivers, COO and Co-founder of delaPlex Software, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.