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Consultations & ED Inpatient care Billing Diagnostic imaging
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The billing team at work inside the hospital

Every patient's folder, ready to submit.

Bill your patients' folders the same day.

−90 %in billing cycle time
−45 %in denials
Try it now See how it works

Eliminate errors of commission and omission when billing.

Plexo analyzes every medical record and bills every item per patient.

Patient documents

Progress notes
Studies
Medications
Supplies
Authorizations

PlexoReading documents

Inpatient stay to billMale patient · 72 years

Procedures

  • 430101Inpatient day, shared room08/24 to 08/28 · x5 · 4 authorizedFacility charges1 day missing
  • 420301Inpatient medical care08/24 to 08/28 · x5Lic. 1824Authorized
  • 420303Inpatient consult · Cardiology08/26 · x1Lic. 2469Authorized

Studies

  • 340301Chest X-ray08/24 and 08/26 · x2Lic. 1629Authorized
  • 170101Electrocardiogram08/24 · x1Lic. 2238Authorized

Medications

  • 10121Ceftriaxone 1 g · vial08/24 to 08/26 · x3MedicationsAuthorized
  • 10003Acetaminophen 1 g · ampoule08/24 to 08/25 · x4MedicationsAuthorized
1 issue: the authorization covers 4 of the 5 inpatient days. Request extension

How it works

The whole billing cycle, from progress note to payment.

Plexo reads the stay, manages authorizations, builds and audits the folder, and knows which provider each service belongs to. Your team approves.

  1. 01 Reads progress notes

    Every progress note, study and order from the stay.

    15 documents read
  2. 02 Manages authorizations

    Checks what's authorized and requests what's missing.

    Extension requested for 1 day
  3. 03 Codes and builds the folder

    Every service with its code and its provider, per the contract.

    7 services coded
  4. 04 Pre-submission audit

    Checks the folder against your institution's rules.

    1 rule to fix
  5. 05 Submission

    Your team approves and the folder is submitted to the payer.

    Submitted to the health plan
  6. 06 Tracked until paid

    Tracking, denials, resubmission and reconciliation.

    Paid and reconciled

Documents read

Progress notes · days 1 to 5Chest X-raysElectrocardiogramsLabsOrders sheetConsult

Authorizations

Inpatient stay · 4 days authorizedDay 5 not authorizedExtension requested from the payer

Coded folder

430101Inpatient day ×5420301Medical care ×5 · Lic. 1824420303Consult ×1 · Lic. 2469340301Chest X-ray ×2 · Lic. 1629170101Electrocardiogram ×1 · Lic. 2238

Your institution's rules

For every CCU day, one electrocardiogram with the study attached.

08/26: admitted to the CCU, but no electrocardiogram was found.

Request the study
Every consult, with the specialist's signed note.
Compliant
Every inpatient day, with its signed progress note.
Compliant

Submission

Approved by billingPayer format and deadlinesSubmitted to the health plan

Tracked until paid

Follow-up

Status of every claim with the payer.

Denial detected

Inpatient day of 08/28 flagged.

Resubmission

Prepared with the approved extension as evidence.

Reconciliation

Paid against submitted, with no pending differences.

Deadline alerts

A heads-up before every resubmission deadline.

Features

The whole cycle, from authorization to payment.

Prior authorizations

Prepares every authorization request and alerts you when an extension is needed.

Coding

Services coded per the fee schedule and each payer's contract.

Pre-submission audit

Checks authorizations, codes and supporting documentation for every item.

Claims to payers

Health plans and insurers, each with its own rules.

Denials and resubmission

Identifies the reason for every denial and prepares the resubmission with the needed evidence.

Payment reconciliation

Matches what was submitted against what was paid and shows what's outstanding.

Revenue cycle
CollectedUSD 482 K1.284 services
Pending collectionUSD 216 K412 submissions
Overdue 60+ daysUSD 64 K27 submissions
Resubmissions38USD 31 K recovered

Status of billed claims

  • Collected 61%
  • Pending 27%
  • Delayed 8%
  • Denied 4%
PayerMarginDenialsDays to pay
Galeno18%9,8%74
Swiss Medical31%2,1%32
OSDE22%4,9%58

Galeno: 12 denials for missing authorizationPlexo prepared the resubmission with the backup for each case.

Resubmit

Visibility across the whole revenue cycle.

What was submitted, what's flagged and what's outstanding, by payer and by department.

  • Every claim tracked until it's paid
  • Denial reasons identified and organized
  • Each payer's contract loaded and up to date

Frequently asked questions

What people ask us most.

Can't find your answer?

Write to us and we'll discuss it.

Write to us
Does Plexo submit without our review?

No. Plexo prepares and checks every claim; your billing team reviews and approves it before it's sent.

Does it work with each payer's contract?

Yes. We load the contracts and rules of every health plan or insurer your institution works with.

What about denials?

Plexo identifies the reason for every denial, finds the evidence in the clinical record and prepares the resubmission for your team to approve.

Do we also need to use Plexo for clinical documentation?

No. Billing works with the clinical record your institution already uses.

Try it with your institution's claims.

We'll show you the full cycle, from authorization to payment, with the payers you work with.

Try it now

Other use cases

Consultations & EDThe note ready when every encounter ends. Inpatient careProgress notes with the patient's full context. Diagnostic imagingFrom dictation to signed report.