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Average Ratings 0 Ratings
Description
PLEXIS offers a comprehensive suite of top-tier applications designed to equip payers with the advanced capabilities required for contemporary core administrative systems. These applications encompass functionalities such as real-time benefit management, adjudication, automated EDI transmission, and self-service customer portals, ensuring that PLEXIS Business Apps meet all your needs. The Passport feature facilitates crucial connections between core administration and claims management systems, PLEXIS business applications, custom applications, and existing internal systems. Its adaptable API layer allows for real-time integration with various portals, automated workflow tools, and business applications, ensuring that connectivity knows no bounds. By employing this centralized, modern core administration and claims management platform, you can enhance workflows effectively. This approach enables the efficient processing of claims while simplifying the complexities associated with benefit administration, resulting in a swift return on investment and the ability to provide exceptional customer service. Ultimately, PLEXIS empowers organizations to thrive in an increasingly complex healthcare landscape.
Description
Riskonnect Claims Management Software is an advanced claims administration platform that helps organizations efficiently manage claims from the initial incident report to final closure. The system centralizes claims information, automates workflows, and connects data from multiple internal and external sources to improve visibility and streamline operations. Businesses can use the platform to simplify claims intake with mobile-friendly forms, automatic alerts, instant data validation, and real-time access to critical information. The software includes robust capabilities for assignment management, reserve tracking, adjudication workflows, settlement processing, subrogation management, and return-to-work coordination. Integrated AI and predictive analytics tools help claims teams identify litigation risks, detect potential problem claims early, estimate claim durations, and make faster, more informed decisions. Riskonnect also supports compliance management through electronic filing tools for workers’ compensation reporting and proactive monitoring of regulatory requirements. Collaboration features enable adjusters, claimants, insurers, and third-party partners to communicate and share information more effectively throughout the claims process. The platform integrates with more than 900 external systems used by carriers and third-party administrators, allowing organizations to unify and validate claims data across different environments. Custom dashboards, reporting tools, and analytics capabilities provide actionable insights that help businesses evaluate performance, reduce costs, and optimize resource allocation. Automated task management and configurable workflows reduce administrative burdens while helping organizations accelerate claim resolution times.
API Access
Has API
API Access
Has API
Integrations
Rayven
Pricing Details
No price information available.
Free Trial
Free Version
Pricing Details
No price information available.
Free Trial
Free Version
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Vendor Details
Company Name
PLEXIS Healthcare Systems
Founded
1996
Country
United States
Website
www.plexishealth.com/platforms/
Vendor Details
Company Name
Riskonnect
Founded
2007
Country
United States
Website
riskonnect.com/claims-management-software/
Product Features
Benefits Administration
COBRA Administration
Claims Management
Deduction Management
Disability Insurance Administration
Employee Benefits Administration
FMLA Administration
FSA Administration
Flexible Spending Accounts
For Brokers
For Employers
HIPAA Compliant
Health Insurance Administration
Life Insurance Administration
Online Benefits Enrollment
Premium Billing
Provider Management
Retiree Administration
Retirement Plan Management
Claims Processing
Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration
Product Features
Claims Processing
Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration
Insurance Claims Management
CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting