One Team Health Announces Expanded Health Claims Management Services

Powered by PLEXIS’ Canopy Care Management

(Markham, Ontario and Ashland, Oregon – September 24, 2020)

One Team Health, a leading provider of managed care services for health insurers and their members, announces a significant expansion of its service offerings based on technology from PLEXIS Healthcare Systems (PLEXIS). One Team Health (OTH) launched the PLEXIS Canopy Care Management solution in service of 20,000 insured members.

PLEXIS recently launched Canopy to address a market need for a comprehensive case management solution, which may be integrated with existing PLEXIS claims platforms or stand-alone as a solution that can work with other applications. Canopy helps clients better manage data to drive increased collaboration and enhanced efficiencies, leading to better outcomes for members and insurers. One Team Health stands by the principles to support a more personalized, proactive and boutique-style service. The vision for One Team Health is a company where patients come first and professional care is backed by innovative technologies. The team is comprised of physicians, nurses, case managers, and care associates with a combined tenure and experience of servicing patients and global insurers for over 50 years.

Canopy features the capability to integrate data from a claims system and other sources, to quickly and efficiently manage tasks/activities for active cases and assessments associated with those cases. OTH currently has 25 users leveraging Canopy to drive effective and efficient outcomes across the thousands of member cases that OTH manages annually. Canopy enables teams to operate at high capacity through member-centric data views. For instance, OTH staff can quickly refer members to network providers, including Centers of Excellence, and provide concurrent and ongoing utilization management, all while providing exceptional concierge services for members in need.

“The OTH team executed a thorough evaluation and testing of the Canopy platform, and PLEXIS has demonstrated the ability to deliver a reliable, functionally-rich solution for our case management needs, which also integrates well with the PLEXIS Quantum Choice claims platform. We are pleased to be using the Canopy application to support our 24/7 operation which supports members, providers, and insurers around the world.” commented OTH VP of Operations, Peter Muir.

Since 2017, OTH has served the overseas claims management needs for international health insurers, with outstanding results and customer service.

“OTH’s capabilities integrate perfectly with our operations and systems and this union creates a holistic view that improves quality of care for our members. The integrated approach allows us to coordinate care with a refined set of providers that are renowned for delivering better results, and quality outcomes. We are continually finding ways to evolve and enhance our business model to better balance quality care and affordability.”

Chief Executive Officer, Major Regional Health Insurer

For more information about One Team Health’s value-added service offerings and PLEXIS technology solutions, please contact the organizations:

About One Team Health

One Team Health Inc. provides Third Party Administration Support from the office in Markham, Ontario (Canada) for case and claims management to individuals that live, work and travel outside their home countries who require medical care worldwide. We specialize in Medical Case Management, Cost Containment, Claims Management, 24/7 Assistance, Network Management and Administration, and Customized Services.

About PLEXIS Healthcare Systems

PLEXIS Healthcare Systems is a leading payer technology company that delivers trusted enterprise core administration and claims management solutions to healthcare payers and delivery systems around the globe. PLEXIS empowers the business of healthcare, igniting growth, innovation, and efficiencies across diverse business lines for payer organizations.

Based in Southern Oregon, PLEXIS currently serves organizations in 44 US states (doing business in all 50), 15 countries, and over 50 million people worldwide. PLEXIS provides mission-critical solutions that catalyze efficiencies and connect evolving business ecosystems to a wide range of payer organizations.