Pro-Claim Plus, Inc., a full service, SSAE 16 Compliant Third Party Administrator was formed in 1990, in response to the need for efficient and effective management of employee benefit plans. Our commitment is to provide prompt, personalized service, while maintaining the resources necessary to help maximize the efficiency of your plan.
To keep abreast of all changes in ERISA and HIPAA, Pro-Claim Plus, Inc. maintains a professional membership in the Society of Professional Benefit Administrators. (SPBA)
Our commitment to quality, personalized service and cost-effective claims administration is reflected in our corporate mission statement:
The mission of Pro-Claim is to provide superior information management, personal service, resource management, quality assurance, and claim adjudication services to partially self-insured clients In the most technologically advanced, cost efficient and timely manner possible
To that end, Pro-Claim is committed to working with the managed care marketplace as a partner. Our common goal is to engage, implement and administer a wide array of PPO and managed care programs. These programs contribute to the overall quality and cost effectiveness of employee benefit programs for our client's employees and their families. The combination of advanced-yet proven-technology and caring employees manifests an organizational culture that creates and encourages the highest level of customer service to our clients.
Technological Commitment... Operational Excellence... Customer Satisfaction
- For the employer who pays the cost!
- For the patient!
- For the physician!
- For the hospital!
In order to create and maintain exceptional customer service, The Pro-Claim employees are provided both the training and tools required to deliver the highest level of personal service possible. By recognizing and accepting the key role of technology, our employees perform at a level unsurpassed in the marketplace. For example, every piece of correspondence received at Pro-Claim is scanned to a digital image, creating a permanent image of the correspondence. At any time Pro-Claim’s Customer Service Representative has the ability to view and act on the information immediately. Additionally, upon being transferred to large optical disc storage in a secure, climate-controlled area, all paper claim correspondence is shredded.
As another example of technology creating the opportunity to deliver exceptional service, Pro-claim has designed and invested in the Claim Pro Software System, allowing nearly 90% of our claims to be adjudicated automatically. This allows our benefit analysts to focus on complicated and potentially high dollar claims where we have the most potential to positively impact our clients by proper and thorough adjudication. This also provides excellent payment consistency for our provider partners as well.
24/7 Information - "Your Resource"
Pro-Claim has also invested in a high level interactive web based system that provides 24-hour customer service 7 days a week. Employees. Employers, and Providers can check the status of their claims, print Explanations of Benefits and verify eligibility.