|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.
Between the mockups and specs produced by analysts, and resulting applications built by developers, there exists a gulf where projects fail, costs spiral, and applications disappoint. Methodologies like Agile attempt to address this with intensified communication, with partial success but many limitations. In his session at @DevOpsSummit at 19th Cloud Expo, Charles Kendrick, CTO at Isomorphic Software, will present a revolutionary model enabled by new technologies. Learn how business and deve...
Oct. 28, 2016 12:15 AM EDT Reads: 1,584
Enterprises have been using both Big Data and virtualization for years. Until recently, however, most enterprises have not combined the two. Big Data's demands for higher levels of performance, the ability to control quality-of-service (QoS), and the ability to adhere to SLAs have kept it on bare metal, apart from the modern data center cloud. With recent technology innovations, we've seen the advantages of bare metal erode to such a degree that the enhanced flexibility and reduced costs that cl...
Oct. 28, 2016 12:00 AM EDT Reads: 626
SYS-CON Events announced today that Niagara Networks will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Niagara Networks offers the highest port-density systems, and the most complete Next-Generation Network Visibility systems including Network Packet Brokers, Bypass Switches, and Network TAPs.
Oct. 28, 2016 12:00 AM EDT Reads: 1,449
In his session at Cloud Expo, Robert Cohen, an economist and senior fellow at the Economic Strategy Institute, will provide economic scenarios that describe how the rapid adoption of software-defined everything including cloud services, SDDC and open networking will change GDP, industry growth, productivity and jobs. This session will also include a drill down for several industries such as finance, social media, cloud service providers and pharmaceuticals.
Oct. 28, 2016 12:00 AM EDT Reads: 2,152
SYS-CON Events announced today that Transparent Cloud Computing (T-Cloud) Consortium will exhibit at the 19th International Cloud Expo®, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. The Transparent Cloud Computing Consortium (T-Cloud Consortium) will conduct research activities into changes in the computing model as a result of collaboration between "device" and "cloud" and the creation of new value and markets through organic data proces...
Oct. 27, 2016 10:30 PM EDT Reads: 1,508
SYS-CON Media announced today that @WebRTCSummit Blog, the largest WebRTC resource in the world, has been launched. @WebRTCSummit Blog offers top articles, news stories, and blog posts from the world's well-known experts and guarantees better exposure for its authors than any other publication. @WebRTCSummit Blog can be bookmarked ▸ Here @WebRTCSummit conference site can be bookmarked ▸ Here
Oct. 27, 2016 10:30 PM EDT Reads: 9,800
Intelligent machines are here. Robots, self-driving cars, drones, bots and many IoT devices are becoming smarter with Machine Learning. In her session at @ThingsExpo, Sudha Jamthe, CEO of IoTDisruptions.com, will discuss the next wave of business disruption at the junction of IoT and AI, impacting many industries and set to change our lives, work and world as we know it.
Oct. 27, 2016 10:30 PM EDT Reads: 541
In today's uber-connected, consumer-centric, cloud-enabled, insights-driven, multi-device, global world, the focus of solutions has shifted from the product that is sold to the person who is buying the product or service. Enterprises have rebranded their business around the consumers of their products. The buyer is the person and the focus is not on the offering. The person is connected through multiple devices, wearables, at home, on the road, and in multiple locations, sometimes simultaneously...
Oct. 27, 2016 10:30 PM EDT Reads: 3,834
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, will discuss why and how ReadyTalk diverted from healthy revenue an...
Oct. 27, 2016 10:30 PM EDT Reads: 3,082
Established in 1998, Calsoft is a leading software product engineering Services Company specializing in Storage, Networking, Virtualization and Cloud business verticals. Calsoft provides End-to-End Product Development, Quality Assurance Sustenance, Solution Engineering and Professional Services expertise to assist customers in achieving their product development and business goals. The company's deep domain knowledge of Storage, Virtualization, Networking and Cloud verticals helps in delivering ...
Oct. 27, 2016 10:15 PM EDT Reads: 1,162
In the 21st century, security on the Internet has become one of the most important issues. We hear more and more about cyber-attacks on the websites of large corporations, banks and even small businesses. When online we’re concerned not only for our own safety but also our privacy. We have to know that hackers usually start their preparation by investigating the private information of admins – the habits, interests, visited websites and so on. On the other hand, our own security is in danger bec...
Oct. 27, 2016 10:15 PM EDT Reads: 677
The Internet of Things (IoT), in all its myriad manifestations, has great potential. Much of that potential comes from the evolving data management and analytic (DMA) technologies and processes that allow us to gain insight from all of the IoT data that can be generated and gathered. This potential may never be met as those data sets are tied to specific industry verticals and single markets, with no clear way to use IoT data and sensor analytics to fulfill the hype being given the IoT today.
Oct. 27, 2016 10:00 PM EDT Reads: 2,910
SYS-CON Events announced today that Hitrons Solutions will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Hitrons Solutions Inc. is distributor in the North American market for unique products and services of small and medium-size businesses, including cloud services and solutions, SEO marketing platforms, and mobile applications.
Oct. 27, 2016 10:00 PM EDT Reads: 2,110
OnProcess Technology has announced it will be a featured speaker at @ThingsExpo, taking place November 1 - 3, 2016, in Santa Clara, California. Dan Gettens, OnProcess’ Chief Analytics Officer, will discuss how Internet of Things (IoT) data can be leveraged to predict product failures, improve uptime and slash costly inventory stock. @ThingsExpo is an annual gathering of IoT and cloud developers, practitioners and thought-leaders who exchange ideas and insights on topics ranging from Big Data in...
Oct. 27, 2016 09:45 PM EDT Reads: 537
As companies adopt the cloud-to-streamline workflow, deployment hasn’t been very seamless because of IT concerns surrounding security risks. The cloud offers many benefits, but protecting and securing information can be tricky across multiple cloud providers and remains IT’s overall responsibility. In his session at 19th Cloud Expo, Simon Bain, CEO of SearchYourCloud, will address security compliance issues associated with cloud applications and how document-level encryption is critical for sup...
Oct. 27, 2016 09:15 PM EDT Reads: 374