Home/New SaaS Software/PLEXIS Payer Platforms
Updated on: October 21, 2021

What is PLEXIS Payer Platforms ?

PLEXIS Payer Platforms - New SaaS Software

PLEXIS Payer Platforms

Get core administration and claims monitored across the entire business seamlessly
(3 Ratings) Write Review

PLEXIS Payer Platforms is an advanced claims management and core administration solution beneficial for healthcare payers and administrators throughout the world. PLEXIS Payer Platforms enables organisations to expand, innovate, and save money by enabling growth, innovation, and efficiencies across several business lines. The software is capable of reducing operating costs while also improving client satisfaction levels at the same time. It assures access to functionalities like benefits administration, auto-adjudication, instant claim editing, multi-level security, billing administration and capitation capabilities. Moreover, the software’s SQL-based technologies provide a robust technological basis for domestic and worldwide payer success. PLEXIS Payer Platforms intuitive functionalities also turn out to be beneficial for health plans, TPAS, government, international, delegated risk, and speciality groups. It is a trusted leader in the worldwide payer community, with active customers in 15 countries and 37 states within the United States.

PLEXIS Payer Platforms Features

PLEXIS Payer Platforms Technical details

Support Business Hours Online Customer Type Large Enterprises Medium Business Small Business
API NA Location / Phone Number Ashland, Oregon / (877) 475-3947
Deployment SaaS/Web/Cloud Installed - Windows Category New SaaS Software

PLEXIS Payer Platforms Pricing

Pricing ModelQuotation Based
PLEXIS Payer Platforms


  • Claims management, including claim auto-adjudication
  • Benefit administration
  • Robust member and eligibility management
  • Premium billing administration
  • Real-time claim editing
  • Mass claim re-adjudication
  • Intelligent alerts and reporting
  • Provider administration/referrals and authorizations
  • Capitation capabilities
  • Easy-to-manage multi-level security
  • Configurable add-ons such as external Medicare grouper and pricer routines
  • Reference data loaders that automatically load procedure/diagnosis codes, UB04, NCCI data, etc.

Disclaimer: The pricing details were last updated on 03/08/2020 from the vendor website and may be different from actual. Please confirm with the vendor website before purchasing.

Learn more about PLEXIS Payer Platforms pricing.

PLEXIS Payer Platforms FAQs

PLEXIS Payer Platforms offers the following functionalities:

  • Reporting
  • Claims Management
  • Forms Management
  • Alerts
  • Compliance Management
  • Benefits Management
  • HIPAA Compliant

Learn more about PLEXIS Payer Platforms features.

No, PLEXIS Payer Platforms does not provide API.

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PLEXIS Payer Platforms Reviews

Based on 3 Rating(s)
Rating Distribution
  • 66.7 %
  • 33.3 %
  • 0 %
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Todd G
Todd GSource : g2crowd.com
(Reviewed on 01 September 2020) "Experiences using Plexis PCM"

What do you like best?

Supportive Organization, Robust Software. I have managed a Plexis Claims Manager System for over 13 years. The software once configured runs error free.

What do you dislike?

Limited Automation Capabilities, Reporting package needs updating

Recommendations to others considering the product:

It is an excellent solution for Benefits administration and claims payment.

What problems are you solving with the product? What benefits have you realized?

TPA functions, Claims Payment, Authorizations creations, Vendor, Provider and Enrollment management, Benefit Management.

Thomas O
Thomas OSource : g2crowd.com
(Reviewed on 21 August 2019) "PLEXIS Health Insurance Software Review."

What do you like best?

It makes insurance claims management more easy as PLEXIS Payer Platforms streamlines main administrative processes, benefit plans, provider contracting and overall workflow. It delivers streamlined efficiency and automated efficiency as it is rapidly scalable, connected and flexible.

It also comprises of extended business applications, passport connectivity services, claims management and cord administration which makes workflow and customer services more easy and fast.

PLEXIS Payer Platforms automates manual processing, saving costs and increasing administrative efficiency.

What do you dislike?

It does not support mobile devices. It only supports web based platforms and windows phone app.

Recommendations to others considering the product:

I highly recommend it because it can be used in large enterprises, mid size business and small size business. It also offers levels of support such as knowledge base, online support, phone support and video tutorials. So I will recommend it to anyone to use it.

What problems are you solving with the product? What benefits have you realized?

Business analysis which is easy as PLEXIS Payer Platform provides completely customizable reporting for business analytics and business intelligence. The solution offers responsive portal competencies so that third party administrators, providers and members are able to associate, communicate and share information in real time.


Videos on PLEXIS Payer Platforms

PLEXIS Payer Platform Explainer
PLEXIS Payer Platform Explainer




The research is compiled using multiple sources, let us know of any feedback on feedback@saasworthy.com