PLEXIS Announces Product Update

PLEXIS expands its Passport connectivity (web) services for use with the PLEXIS Claims Manager platform

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PLEXIS Healthcare Systems is pleased to announce the release of its new web service-based API for PLEXIS Claims Manager (PCM), known as PCM-AIS (Application Interface Services), which are part of its larger Passport connectivity suite of web services. Passport’s PCM-AIS is an API that enables real-time or near real-time data lookup, referred to as “search & retrieve” functions. It also allows for updating data within the PLEXIS Claims Manager (PCM) platform’s database, which are referred to as “add & update” functions. Both are accomplished using standard web service calls and can be quickly coded to using detailed product documentation and code samples (as a "starter kit") provided by PLEXIS.

The initial launch of PCM-AIS enables organizations to interact with commonly used PCM components such as members and eligibility, providers, and referrals and authorization records.

There are many scenarios where using PCM-AIS would improve a health plan or TPA’s business, including but not limited to:

  • Provide live access of data for a health plan or TPA web portal. Allow members and providers to perform a real-time lookup of member, eligibility, or provider data.
  • Enable interoperability with a separate membership source of truth system. Perform automated, real-time lookup and updates of member and eligibility data to keep PCM up to date with other applications.
  • Interface with an external medical management, utilization review, or utilization management system, and have that system perform real-time lookups of member and provider data located in PCM, and insert newly approved referrals or authorizations into PCM.

Each of these examples speaks to workflow automation and ease of systems integration, which can greatly reduce the administrative cost and burden with managing data in multiple systems.

About PLEXIS

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. Since 1996, PLEXIS has helped to empower the business of healthcare, igniting growth, innovation, and efficiencies across diverse business lines for payer organizations. Based in Southern Oregon, PLEXIS currently serves organizations in 44 states (doing business in all 50), 15 countries, and over 70 million people worldwide. PLEXIS provides mission-critical solutions that catalyze efficiencies and connect evolving business ecosystems to a wide range of payer organizations.

To learn more about how PLEXIS platforms can benefit an organization, please contact the PLEXIS Sales team at sales@plexishealth.com or call toll-free 1+ 877-475-3947 and press 1 for Sales.

Source: PLEXIS Healthcare Systems, Inc.

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Categories: Healthcare Insurance

Tags: API, CAPS, claims management, health plan, healthcare payer, PLEXIS, TPA, value-based reimbursement, web services


About PLEXIS Healthcare Systems

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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.

Dan Jimmerson
Director of Marketing, PLEXIS Healthcare Systems
PLEXIS Healthcare Systems
340 Oak Street
Ashland, OR 97520
United States