Claim-Pro System

CLAIM-PRO SYSTEM

Pro-Claim Plus, Inc. has a claim administration system second to none. In this day and age everyone expects great service from a person to person aspect. We provide this without saying so. What stands us apart from the other Third Party Administrators competing for your business is our data processing system used in real-time on-line. It provides the great service we expect from which others have no control. Well, we do.

CLAIM-PRO was developed at Pro-Claim Plus, Inc. by in-house system analyst experts. It is capable of automating all major functions in claim administration. At the onset of automated data processing “on-line” implied the input terminal was connected to a central processing unit. The key concept today is “real-time.” “Real-time” means as a claim is being processed, the system automatically updates its’ files. Immediately after a claim has been processed, maximums, deductibles and claim payment files are updated. A system without “real-time” update seriously impedes expeditious claim processing and can result in processing inaccurate maximum and deductible calculations, and over-utilization of the benefit plan.

Other functions supported by the CLAIM-PRO system include:

¨ Automatically verified eligibility based on coverage periods and types of coverage an employee and dependents are entitled to receive.

¨ Daily, monthly and year-to-date accumulated payment statistics for benefit plan activity reporting.

¨ Extensive standard reporting features.

¨ Non-standard/ad hoc reports designed specifically to meet the needs of our customers.

¨ Record storage by fund account, plan level, location, family, employee and dependents.

As you can see with CLAIM-PRO’s unmatchable flexible capacity, Pro-Claim Plus, Inc. has created another way to better serve you as a customer.

SYSTEM OVERVIEW

Pro-Claim Offers a Windows Based Approach to your Claim Adjudication Needs