PLEXIS Healthcare Systems Unveils Next-Generation AI Innovations to Empower Healthcare Payers

AI-enhanced Quantum Choice and PCM solutions put compliance, efficiency, and innovation at the core of payer operations.

Our clients don’t need AI hype—they need outcomes with fewer errors, faster claims cycles, and lower administrative costs. With AI copilots and agents, PLEXIS clients will see those results.”

— Sean Garrett, COO of PLEXIS

ASHLAND, OR, UNITED STATES, September 30, 2025 /EINPresswire.com/ -- At its 2025 User Conference, PLEXIS Healthcare Systems unveiled a suite of agentic AI copilots and workflow agents designed to empower healthcare payers with measurable efficiency, stronger compliance, and greater member and provider satisfaction. With more than 30 million lives administered worldwide, PLEXIS is putting real-world AI into action where it matters most: payer operations.

“Competitors are talking about the promise of AI. PLEXIS is building it with client feedback influencing every step.” said Mark Sullivan, VP of AI Innovations at PLEXIS. “Our AI copilots are built to reduce manual effort, cut turnaround times, and free staff to focus on member and provider relationships.”

AI Enhancements Unveiled at the Conference:
• QC Buddy Copilot – A secure in-platform assistant that answers user questions, summarizes EOBs/claims, and equips customer service staff to resolve issues faster.
• Agentic AI Orbit – Modular AI agents supporting claims intake, eligibility checks, provider data management, and premium invoice adjustments. Designed to automate repetitive tasks and reduce errors, these agents are projected to significantly decrease manual rework.

PLEXIS AI Roadmap
The company shared a three-phase AI vision that balances bold innovation with healthcare-grade governance:
1. Internal accelerators – AI tools that boost PLEXIS internal development and support efficiency.
2. Embedded copilots and agents – Practical tools inside QC and PCM that deliver immediate value to clients.
3. Future-ready automation patterns – Scaling safe AI frameworks across the payer ecosystem.

Sean Garrett, COO of PLEXIS, added:
“Our clients don’t need AI hype—they need outcomes. That means fewer errors, faster claims cycles, more satisfied members and employees, and lower administrative costs. With AI copilots and agents, PLEXIS clients will see those results.”

Dennis Hubbard
PLEXIS Healthcare Systems
+1 541-613-3741
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