|By Marketwired .||
|March 4, 2014 06:00 AM EST||
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.
"Qosmos has launched L7Viewer, a network traffic analysis tool, so it analyzes all the traffic between the virtual machine and the data center and the virtual machine and the external world," stated Sebastien Synold, Product Line Manager at Qosmos, in this SYS-CON.tv interview at 19th Cloud Expo, held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA.
Dec. 8, 2016 06:45 PM EST Reads: 917
Without a clear strategy for cost control and an architecture designed with cloud services in mind, costs and operational performance can quickly get out of control. To avoid multiple architectural redesigns requires extensive thought and planning. Boundary (now part of BMC) launched a new public-facing multi-tenant high resolution monitoring service on Amazon AWS two years ago, facing challenges and learning best practices in the early days of the new service. In his session at 19th Cloud Exp...
Dec. 8, 2016 05:45 PM EST Reads: 926
Everyone knows that truly innovative companies learn as they go along, pushing boundaries in response to market changes and demands. What's more of a mystery is how to balance innovation on a fresh platform built from scratch with the legacy tech stack, product suite and customers that continue to serve as the business' foundation. In his General Session at 19th Cloud Expo, Michael Chambliss, Head of Engineering at ReadyTalk, discussed why and how ReadyTalk diverted from healthy revenue and mor...
Dec. 8, 2016 05:45 PM EST Reads: 1,714
As data explodes in quantity, importance and from new sources, the need for managing and protecting data residing across physical, virtual, and cloud environments grow with it. Managing data includes protecting it, indexing and classifying it for true, long-term management, compliance and E-Discovery. Commvault can ensure this with a single pane of glass solution – whether in a private cloud, a Service Provider delivered public cloud or a hybrid cloud environment – across the heterogeneous enter...
Dec. 8, 2016 05:00 PM EST Reads: 1,809
You have great SaaS business app ideas. You want to turn your idea quickly into a functional and engaging proof of concept. You need to be able to modify it to meet customers' needs, and you need to deliver a complete and secure SaaS application. How could you achieve all the above and yet avoid unforeseen IT requirements that add unnecessary cost and complexity? You also want your app to be responsive in any device at any time. In his session at 19th Cloud Expo, Mark Allen, General Manager of...
Dec. 8, 2016 04:45 PM EST Reads: 1,839
Financial Technology has become a topic of intense interest throughout the cloud developer and enterprise IT communities. Accordingly, attendees at the upcoming 20th Cloud Expo at the Javits Center in New York, June 6-8, 2017, will find fresh new content in a new track called FinTech.
Dec. 8, 2016 04:45 PM EST Reads: 2,243
"We are a leader in the market space called network visibility solutions - it enables monitoring tools and Big Data analysis to access the data and be able to see the performance," explained Shay Morag, VP of Sales and Marketing at Niagara Networks, in this SYS-CON.tv interview at 19th Cloud Expo, held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA.
Dec. 8, 2016 04:30 PM EST Reads: 354
@DevOpsSummit taking place June 6-8, 2017 at Javits Center, New York City, is co-located with the 20th International Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. @DevOpsSummit at Cloud Expo New York Call for Papers is now open.
Dec. 8, 2016 04:30 PM EST Reads: 1,962
Keeping pace with advancements in software delivery processes and tooling is taxing even for the most proficient organizations. Point tools, platforms, open source and the increasing adoption of private and public cloud services requires strong engineering rigor - all in the face of developer demands to use the tools of choice. As Agile has settled in as a mainstream practice, now DevOps has emerged as the next wave to improve software delivery speed and output. To make DevOps work, organization...
Dec. 8, 2016 04:15 PM EST Reads: 279
The 20th International Cloud Expo has announced that its Call for Papers is open. Cloud Expo, to be held June 6-8, 2017, at the Javits Center in New York City, brings together Cloud Computing, Big Data, Internet of Things, DevOps, Containers, Microservices and WebRTC to one location. With cloud computing driving a higher percentage of enterprise IT budgets every year, it becomes increasingly important to plant your flag in this fast-expanding business opportunity. Submit your speaking proposal ...
Dec. 8, 2016 04:15 PM EST Reads: 2,308
"We are a modern development application platform and we have a suite of products that allow you to application release automation, we do version control, and we do application life cycle management," explained Flint Brenton, CEO of CollabNet, in this SYS-CON.tv interview at DevOps at 19th Cloud Expo, held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA.
Dec. 8, 2016 04:00 PM EST Reads: 1,074
Amazon has gradually rolled out parts of its IoT offerings in the last year, but these are just the tip of the iceberg. In addition to optimizing their back-end AWS offerings, Amazon is laying the ground work to be a major force in IoT – especially in the connected home and office. Amazon is extending its reach by building on its dominant Cloud IoT platform, its Dash Button strategy, recently announced Replenishment Services, the Echo/Alexa voice recognition control platform, the 6-7 strategic...
Dec. 8, 2016 03:48 PM EST Reads: 312
Regulatory requirements exist to promote the controlled sharing of information, while protecting the privacy and/or security of the information. Regulations for each type of information have their own set of rules, policies, and guidelines. Cloud Service Providers (CSP) are faced with increasing demand for services at decreasing prices. Demonstrating and maintaining compliance with regulations is a nontrivial task and doing so against numerous sets of regulatory requirements can be daunting task...
Dec. 8, 2016 03:45 PM EST Reads: 1,081
Bert Loomis was a visionary. This general session will highlight how Bert Loomis and people like him inspire us to build great things with small inventions. In their general session at 19th Cloud Expo, Harold Hannon, Architect at IBM Bluemix, and Michael O'Neill, Strategic Business Development at Nvidia, discussed the accelerating pace of AI development and how IBM Cloud and NVIDIA are partnering to bring AI capabilities to "every day," on-demand. They also reviewed two "free infrastructure" pr...
Dec. 8, 2016 03:30 PM EST Reads: 1,225
"This is specifically designed to accommodate some of the needs for high availability and failover in a network managed system for the major Korean corporations," stated Thomas Masters, Managing Director at InfranicsUSA, in this SYS-CON.tv interview at 19th Cloud Expo, held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA.
Dec. 8, 2016 03:15 PM EST Reads: 313