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
DX World EXPO, LLC, a Lighthouse Point, Florida-based startup trade show producer and the creator of "DXWorldEXPO® - Digital Transformation Conference & Expo" has announced its executive management team. The team is headed by Levent Selamoglu, who has been named CEO. "Now is the time for a truly global DX event, to bring together the leading minds from the technology world in a conversation about Digital Transformation," he said in making the announcement.
"Space Monkey by Vivent Smart Home is a product that is a distributed cloud-based edge storage network. Vivent Smart Home, our parent company, is a smart home provider that places a lot of hard drives across homes in North America," explained JT Olds, Director of Engineering, and Brandon Crowfeather, Product Manager, at Vivint Smart Home, in this SYS-CON.tv interview at @ThingsExpo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
SYS-CON Events announced today that Conference Guru has been named “Media Sponsor” of the 22nd International Cloud Expo, which will take place on June 5-7, 2018, at the Javits Center in New York, NY. A valuable conference experience generates new contacts, sales leads, potential strategic partners and potential investors; helps gather competitive intelligence and even provides inspiration for new products and services. Conference Guru works with conference organizers to pass great deals to gre...
DevOps is under attack because developers don’t want to mess with infrastructure. They will happily own their code into production, but want to use platforms instead of raw automation. That’s changing the landscape that we understand as DevOps with both architecture concepts (CloudNative) and process redefinition (SRE). Rob Hirschfeld’s recent work in Kubernetes operations has led to the conclusion that containers and related platforms have changed the way we should be thinking about DevOps and...
The Internet of Things will challenge the status quo of how IT and development organizations operate. Or will it? Certainly the fog layer of IoT requires special insights about data ontology, security and transactional integrity. But the developmental challenges are the same: People, Process and Platform. In his session at @ThingsExpo, Craig Sproule, CEO of Metavine, demonstrated how to move beyond today's coding paradigm and shared the must-have mindsets for removing complexity from the develop...
In his Opening Keynote at 21st Cloud Expo, John Considine, General Manager of IBM Cloud Infrastructure, led attendees through the exciting evolution of the cloud. He looked at this major disruption from the perspective of technology, business models, and what this means for enterprises of all sizes. John Considine is General Manager of Cloud Infrastructure Services at IBM. In that role he is responsible for leading IBM’s public cloud infrastructure including strategy, development, and offering m...
The next XaaS is CICDaaS. Why? Because CICD saves developers a huge amount of time. CD is an especially great option for projects that require multiple and frequent contributions to be integrated. But… securing CICD best practices is an emerging, essential, yet little understood practice for DevOps teams and their Cloud Service Providers. The only way to get CICD to work in a highly secure environment takes collaboration, patience and persistence. Building CICD in the cloud requires rigorous ar...
Companies are harnessing data in ways we once associated with science fiction. Analysts have access to a plethora of visualization and reporting tools, but considering the vast amount of data businesses collect and limitations of CPUs, end users are forced to design their structures and systems with limitations. Until now. As the cloud toolkit to analyze data has evolved, GPUs have stepped in to massively parallel SQL, visualization and machine learning.
"Evatronix provides design services to companies that need to integrate the IoT technology in their products but they don't necessarily have the expertise, knowledge and design team to do so," explained Adam Morawiec, VP of Business Development at Evatronix, in this SYS-CON.tv interview at @ThingsExpo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
To get the most out of their data, successful companies are not focusing on queries and data lakes, they are actively integrating analytics into their operations with a data-first application development approach. Real-time adjustments to improve revenues, reduce costs, or mitigate risk rely on applications that minimize latency on a variety of data sources. In his session at @BigDataExpo, Jack Norris, Senior Vice President, Data and Applications at MapR Technologies, reviewed best practices to ...
Widespread fragmentation is stalling the growth of the IIoT and making it difficult for partners to work together. The number of software platforms, apps, hardware and connectivity standards is creating paralysis among businesses that are afraid of being locked into a solution. EdgeX Foundry is unifying the community around a common IoT edge framework and an ecosystem of interoperable components.
"ZeroStack is a startup in Silicon Valley. We're solving a very interesting problem around bringing public cloud convenience with private cloud control for enterprises and mid-size companies," explained Kamesh Pemmaraju, VP of Product Management at ZeroStack, in this SYS-CON.tv interview at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
Large industrial manufacturing organizations are adopting the agile principles of cloud software companies. The industrial manufacturing development process has not scaled over time. Now that design CAD teams are geographically distributed, centralizing their work is key. With large multi-gigabyte projects, outdated tools have stifled industrial team agility, time-to-market milestones, and impacted P&L stakeholders.
"Akvelon is a software development company and we also provide consultancy services to folks who are looking to scale or accelerate their engineering roadmaps," explained Jeremiah Mothersell, Marketing Manager at Akvelon, in this SYS-CON.tv interview at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
Enterprises are adopting Kubernetes to accelerate the development and the delivery of cloud-native applications. However, sharing a Kubernetes cluster between members of the same team can be challenging. And, sharing clusters across multiple teams is even harder. Kubernetes offers several constructs to help implement segmentation and isolation. However, these primitives can be complex to understand and apply. As a result, it’s becoming common for enterprises to end up with several clusters. Thi...