Pennsylvania PACE Health Plan Digitizes Their Care for the Elderly With PLEXIS Core Admin Technology for Payers

PLEXIS Healthcare Systems

PACE benefits include, but aren't limited to, all Medicaid and Medicare-covered services. PLEXIS enterprise core administrative platforms enable greater interoperability with advanced EDI technology.

PLEXIS Healthcare Systems, a leading healthcare payer technology company and innovator in next-generation digital core administrative processing solutions (CAPS), today announced another payer administrator selecting PLEXIS Claims Manager (PCM) to meet the needs of a growing membership within the CMS program known as the "Program of All-Inclusive Care for the Elderly" or PACE.

One of the key reasons for selection was PCM's real-time and batch integration (API/web services, x12 EDI) technology that assists health plans/insurers, TPAs, delegated entities, and other payers in achieving digital transformation of their enterprise.

Gartner, a technological research and consulting firm, affirms the industry-wide need for payers to evolve to the "All-Digital" paradigm by defining the Digital Healthcare Payer Platform. "The Digital Healthcare Payer Platform (DHPP) is an architectural approach that enables payers to adapt their business and operating models in response to external disruption and changes in business strategy." 

"Constant regulatory and market disruptors within the payer industry are driving an ever-increasing adoption of scalable, flexible, and interoperable core administrative platforms to deliver health value within the dynamic future of healthcare," said Sean Garrett, chief operating officer for PLEXIS Healthcare Systems. "It is incumbent upon leading-edge payer technology providers, like PLEXIS, to provide a path of least resistance towards digital transformation and acceleration into the future of digital healthcare."

About PLEXIS Healthcare Systems

Celebrating 25 years of service, PLEXIS Healthcare Systems is a leading payer technology company that delivers trusted enterprise core administration and claims management solutions to healthcare payers and delivery systems around the globe. More than 100 organizations trust PLEXIS core administrative enterprise solutions to manage over 55 million lives in all 50 states and around the world. PLEXIS provides mission-critical solutions that catalyze efficiencies and connect evolving business ecosystems to a wide range of payer organizations. PLEXIS Healthcare Systems is featured in Gartner's 2022 Market Guide for U.S. Healthcare Payers' Core Administrative Processing Solutions (February 2022) as a Representative Vendor.


Source: PLEXIS Healthcare Systems