Business Process Outsourcing Administration and Risk Mitigation in Africa

“We provide advanced healthcare IT solutions for people in Nigeria by implementing the latest technology solutions that offer ease of use and lower the cost of operation and support. We help payers save millions by improving accuracy, efficiency, and performance through the powerful analytics and automation of the PLEXIS platform.”–Doyin Famodu, CEO of IGHS

PLEXIS streamlines administration of BPO services in Africa through its strategic partnership with Intuitive Global Healthcare Systems (IGHS) to leverage the world-class PLEXIS payer platform to empower cost-saving claims management, business process outsourcing (BPO), and multiple next-generation healthcare solutions to transform the payer landscape in Africa.

BPO Streamlined through PLEXIS’ Core Amininistration 2.0

IGHS and other BPO administrators leverage the new industry standard—PLEXIS’ Core Administration 2.0—to provide an enhanced toolset for its payers including accurate electronic claims processing, highly-automated payer-provider network management, and business intelligence. Claims can now be reimbursed in less than ten minutes instead of taking two to three weeks. The results include much greater customer satisfaction and new levels of accountability and accuracy. The PLEXIS platform also includes advanced reporting capabilities that empower payers with the intelligent oversight to improve population health management.

The PLEXIS platform streamlines administration of Business Process Outsourcing to:

  • Enhance provider networks: PLEXIS’ unified platform streamlines workflows for provider engagement. PLEXIS automates support for provider network management for multiple reimbursement arrangements allowing you to enhance collaboration with providers and members.
  • Effectively predict costs: PLEXIS can integrate powerful business analytics (BI/BA) to enable predictive modeling and data mining to control costs and maximize health benefits by providing actionable intelligence for effective cost containment
  • Rapidly respond to critical conditions: Payers keep costs from spiraling out of control through early identification of outliers and critical health issues. PLEXIS empowers you with configurable alerts, automatic audits, incisive health risk assessments (HRAs), and responsive reporting.
  • Enhance automation and efficiencies: PLEXIS empowers efficient fraud, waste, and abuse (FWA) detection, automated claim editing, automated calculations and processing of network fees, and powerful electronic data interchange (EDI) solutions.
  • Meet cost containment objectives: PLEXIS automates complex benefit calculations to drive high auto-adjudication rates and minimize the risk of paying claims incorrectly. Payers recover significant savings and reduce utilization rates by leveraging PLEXIS’ real-time alerts, automatic audits, health risk assessments (HRAs), responsive reporting, and more.
  • Lower utilization rates and close care gaps with coordinated care: PLEXIS can integrate care management, UM/UR, and disease management to enable powerful, preventative, outcome-based wellness. We include capabilities for medical management negotiations, data-driven utilization review, wellness services, and monitoring/management of high-dollar claims.
  • Enhance transparency for evolving compliance requirements: Accelerate growth while minimizing risk through end-to-end transparency and centralized premium and claim data. PLEXIS provides holistic visibility for compliance requirements.

About Intuitive Global Healthcare Systems

Intuitive Global Healthcare Systems is a global healthcare management and medical information technology company with a mission to improve outcomes for stakeholders in the global healthcare industry. Headquartered in Nigeria, Intuitive is a subsidiary of Korak Healthsource, Inc. Healthcare industry and IT veterans created Intuitive with the vision to transform Healthcare IT solutions in the developing world.

Intuitive has deployed solutions internationally in India, UAE, Oman, Bahrain, Nigeria, Kenya, and more. Intuitive provides solutions to healthcare payer groups, healthcare provider networks, and government agencies, enabling them to achieve maximum results for greater quality of care and operational and clinical outcomes.

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