Encore Health Network Leverages Investment in Next Generation CAPS Technology to Increase Efficiency and Scalability

Encore Health Network engages next generation CAPS platform from PLEXIS to help further optimize its Healthcare claim repricing operation.

MEDFORD, OR, UNITED STATES, April 2, 2024 /EINPresswire.com/ — Encore Health Network (Encore), a leading regional preferred provider organization (PPO) specializing in healthcare claim repricing for self-funded employer groups, has announced the successful implementation of Quantum Choice (QC), a cutting-edge core administrative processing solution (CAPS) platform developed by PLEXIS Healthcare Systems.

As a pivotal intermediary between submitting healthcare providers and payers, Encore plays a critical role in the repricing of healthcare claims. With the integration of Quantum Choice, Encore is poised to streamline and optimize their repricing workflows, enhancing efficiency and scalability while maintaining their commitment to accuracy and precision.

Quantum Choice is designed to meet the unique needs of organizations like Encore, focusing on the intricacies of claim repricing. QC offers advanced capabilities tailored specifically to the repricing landscape, empowering Encore Health to excel in their core strength at repricing billed charges and facilitating seamless claim adjudication with payers.

“We are thrilled to leverage the power of Quantum Choice from PLEXIS Healthcare Systems to further elevate our repricing capabilities,” said Shawn Gibbons, Vice President of Development at Encore. “This strategic implementation aligns seamlessly with our mission to enhance the repricing process, ensuring accuracy and efficiency in our interactions with both healthcare providers and payers.”

The partnership between Encore Health Network and PLEXIS Healthcare Systems signifies a commitment to innovation and excellence within the realm of healthcare claim repricing. Encore is poised to reinforce its position as a trusted leader in the regional PPO landscape, delivering accurate and efficient repricing services.

“We stand at the forefront of the healthcare payer digital evolution, ensuring that our claims processing and repricing performance not only meets the demands of today, but paves the way for tomorrow,” said Jose Lopez, Chief Revenue Officer at PLEXIS. “Quantum Choice embodies our dedication to providing solutions that resonate with the dynamic needs of healthcare payers, TPAs, and repricing organizations.”

About Encore Health

Encore Health Network is committed to supporting the Third-Party Administrator (TPA) and Broker markets in Indiana and Kentucky by providing the highest quality, cost effective PPO Network for both employers and employee health and workers compensation network needs. With a focus on accuracy, efficiency, seamless interactions with healthcare providers and payers and over 35 years of experience, Encore is the PPO Network leader in Indiana serving several hundred thousand members. Encore’s primary commitment is to its members and assures access to an extensive provider network with a flexible menu of services and network products at competitive pricing with outstanding customer service.

About PLEXIS Healthcare Systems

PLEXIS Healthcare Systems is a leading payer technology company delivering trusted enterprise core administration and claims management solutions to healthcare payers and delivery systems worldwide. More than 115 organizations trust PLEXIS core administrative enterprise solutions to manage millions of 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 has been named a Sample Vendor in Gartner’s Hype Cycle for U.S. Healthcare Payers, 2023 report. PLEXIS has also been positioned as a Major Contender within Everest Group’s Healthcare Cloud-based Core Administration Platforms PEAK Matrix Assessment 2023. PLEXIS leverages cloud hosting, next-generation BPO, open APIs, modular solutions, highly configurable benefit administration, and greater visibility with ready access to real-time data.

Dennis Hubbard
PLEXIS Healthcare Systems
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