1. Claim Remedi Services, Inc.
Training Document

2. Pro837™ Contents Overview Pro837 ProIdentify ProClaimSubmit
New Provider Process
Contract and Business Associate Agreement
Sales Talking Points
Sample Savings
Contact Information
All documentation available on website

3. Industry Overview
In the U.S., $1.5 trillion is spent on healthcare annually
A significant portion of this figure is wasted on inefficient healthcare administration systems
“Cost control” in the healthcare industry has traditionally referred only to capping medical expenditures
Further reducing payments to providers is difficult and will likely result in only small gains
Therefore, the emphasis has shifted to reducing administrative costs.
Administrative costs account for half of total cost of healthcare
HIPAA contributed to the focus on administrative reductions by emphasizing electronic data interchange.
Our software solutions target several inefficient areas of healthcare administration:
claim editing
determination of patient insurance eligibility
claim submission

4. Product Overview Pro837™: Our exclusive state-of-the-art claims editor
Saves the average provider $20,000 to $50,000 annually
Almost completely eliminates reprocessing rejected claims
Reduces your receivables by 20% or more
Improves your cash flow by $25,000 or more
Simple to set-up and use.
ProIdentify™: Our all-payer eligibility solution
Determines patient eligibility in seconds
Provides eligibility and benefit information for most Medicare, Medicaid, Blue Cross and commercial payers
ProClaimSubmit™: Our all-payer clearinghouse solution
Reduce your cost of claim submission by 60% to 80% to less than $1.00
Reduce or eliminate labor and material costs associated with printing, sorting and mailing claims
No special hardware or software required

5. Available Sales Tools Provider Tri-fold PowerPoint Presentation
Can be tailored for your distribution needs
For direct sales and telemarketing follow-up
PowerPoint Presentation
For web-based direct marketing
For additional information from telemarketing queries
Can easily be tailored for individual providers
On-line product demonstrations
Product demonstrations can be added directly to your web site
Substantial product detail available for print and other media
Potential to link to for similar products.
Provider Savings Tool
Summary level
Calculate savings to the provider based on number of patient visits per month

6. Document Review Contract / Business Associate Agreement
Required for all individual providers / groups
Copies faxed to:
Originals mailed with installation check to:
1434 West 11th Street, Los Angeles, CA 90015
Pricing Document
Installation / software costs
21 days free
Monthly fees
Billing Process

7. Pro837™ Why does a Provider need Pro837?
Each day healthcare providers across the country submit claims to a number of payers. For most providers, after waiting about 45 days, 30% to 40% of those claims are rejected and returned unpaid. Hours are spent researching, editing and resubmitting those claims. Every time you need to fix these rejects it costs between $12.50 and $25.00 per claim. If these claims are corrected properly, payment is received in another 45 days.
What will Pro837 do for the provider?
Pro837™ puts a stop to the insanity! It’s easy to set-up, simple to use and very affordable. If your office sees 350 patients monthly Pro837 saves between $20,000 and $50,000 annually. These savings come from reducing eligible first claim (HIPAA 837) rejects from 30% - 40% to 3% or less! Pro837 almost completely eliminates the need to reprocess rejected claims, reduces your receivables by 20% or more and improves your cash flow by $25,000 or more.  

8. Pro837™: Key Features
No special hardware or software needs — only a PC with Internet Explorer and Internet access.
Automated interface with the Patient Accounting System (PAS) enables downloading validated claims and uploading notes. This eliminates monotonous and error-prone chores of the business office staff
The software is automatically updated weekly 
Works for all payers

9. Pro837™ Screen Shots: Claim List with Errors

10. Pro837™ Screen Shots: Error Report

11. Pro837™ Screen Shots: Payer Response

12. ProIdentify™ Why does a provider need ProIdentify?
Each day healthcare providers across the country spend valuable time in phone calls with payers to determine coverage for new and existing patients. Are they covered? What level of coverage exists? What co-pay does the patient have?
 What will ProIdentify do for the provider?
ProIdentify™ puts a stop to the insanity! It’s easy to set-up, simple to use and very affordable – especially compared to the labor costs of sitting on the phone. If your office verifies eligibility on as few as 20 patients monthly, ProIdentify saves over $1,200 Annually. These savings do not include the improvement in Accounts Receivable and patient satisfaction.

13. ProIdentify™ Key Features
ProIdentify lets you
Receive eligibility and benefit information from most Medicare, Medicaid, Blue Cross and commercial payers
No special equipment required
ProIdentify can also facilitate automated electronic benefits queries for many payers.

14. ProIdentify™ Screen Shots: New Eligibility

15. ProIdentify™ Screen Shots: Response Summary

16. ProIdentify™ Screen Shots: Response Detail

17. ProIdentify™ Screen Shots: Payer Reference Report

18. ProClaimSubmit™: Overview and Features
Why does a provider need ProClaimSubmit?
Each day healthcare providers across the country submit claims to a number of payers. For most providers, this means printing, sorting and mailing out the claims.
What will ProClaimSubmit do for the provider?
ProClaimSubmit puts a stop to the insanity! It’s easy to set-up, simple to use and very affordable, especially compared to labor costs associated with all of the printing, sorting and mailing that your staff is doing. Each claim produced costs $3.00 to $5.00 — ProClaimSubmit can reduce this cost to less than $1.00.
Features:
An all payer solution, provides claims-clearing technology
No special hardware or software required
No printing, mailing or long distance costs
Filtering tools make working in a multiple facilities environment manageable and customizable
Automated interface with the PAS enables downloading validated claims and uploading notes
Eliminates monotonous and error prone chores of business office staff

19. New Provider Process: Pro837Pak
Provider fills out and submits the required application forms and documents.
Call to Provider within 24 hours of the receipt of documents, explain process and confirm information on forms.
confirmation of information on forms sent to Provider contact.
Populated enrollment documents sent to Provider contact with return envelope.
Receive enrollment documents via mail, completed and signed.
Sample eligibility information submitted.
Sample claims submitted.
Call to Provider to run eligibility test file and confirm success.
Receive results, review results with Provider, go live.
Call to Provider to run claim test file and confirm success.
Upload claim file.
Receive results, review results with Provider.
Download configured editor from CR to Provider’s site.
Train Provider remotely, go live.
Clearinghouse functionality live schedule sent to Provider.

20. Contract – Business Associate Agreement
The contract that the provider’s office enters into is essentially a standard document outlining the basic terms and conditions for the use of our products. , the Business Associate Agreement (“BAA”) is a document that we are legally required to obtain in order to handle medical records that the provider’s office submits to us. The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”)
A provider information sheet is amended to the contract and BAA. In this document we acquire information necessary for three parts of the implementation process: (a) contact information to facilitate the overall enrollment process, (b) information necessary for Pro837 to proofread the claims and (c) information needed to facilitate the filling out of enrollment documents for ProClaimSubmit. The information sheet asks for the following information:

21. Contract – Business Associate Agreement
Provider Name
Mailing Address
Tax ID Number
Contact Name
Contact Title
Contact Phone Number
Contact Fax Number
Contact Address
Response Reports
Practice Management System
Format
Provider Middle Name
Provider Title
Provider Specialty
Provider Social Security Number
Employer ID Number
State License Number
Universal Provider ID Number (UPIN)
Physician ID Number (PIN)
Medicare Part A Number
EOB/Check Address
Place of Service Address
Group Name
Group Provider Number
Group Tax ID Number

22. Contract – Business Associate Agreement
In addition, the information sheet also asks for the payers that the provider submits claims to, the number that each payer assigned the provider and the estimated volume of claims that the provider submits to each payer.
Most of the information is used for enrollment in electronic submission systems for a provider’s healthcare claims (for ProClaimSubmit). Each payer requires a form containing information in order to set up their system to receive claims from a provider. To make the implementation process as smooth as possible, instead of just giving the provider’s office blank forms for each of their payers (usually over 10) and having the office fill in the same information on each, we ask for the information in the contract and fill in the information sections on each form before sending them to their office. When the provider’s office receives the enrollment documents (by or fax), all of the informational fields will be filled out already – all they have to do is sign and send them back.

23. Sales Talking Points – Pro837
30% - 40% of back office work is doing something over that should have been done right the first time – don’t you think that’s kind of inefficient? When you have 30% - 40% of your claims rejected, you aren’t receiving 30% - 40% of your payment and you’re spending $12.50 per rejected claim to rework and resubmit it.
Pro837 proofreads your claims before they’re submitted and reduces your reject rate to less than 3%.

24. Sales Talking Points – ProIdentify
When patients come into your office, you have three choices: (a) assume the patient is covered, (b) spend 20 minutes on the phone with the insurance company determining the existence and level of coverage and (c) spend 7 seconds and get paid today. If you assume the patient is covered, around 10% of your claims will be denied due to lack of coverage and you’ll have to bill the patient an average of 3 times for the co-pay you should have collected. If you spend 20 minutes on the phone, you’re paying a member of your office staff over $6.00 to determine coverage.
ProIdentify allows you to determine eligibility electronically in mere seconds.

25. Sales Talking Points – ProClaimSubmit
At every insurance company, paper claims get processed last. If you want to get your claims out to payers and have them processed as efficiently as possible, you need to send them electronically.
ProClaimSubmit allows you to submit all of your claims electronically to all of your payers.

26. Sample Savings

27. Price Sheet We feature Monthly Package and A La Carte Pricing :
The Package features:
Pro837™
ProIdentify™
ProClaimSubmit™

28. Claim Remedi Services, Inc.
Contact Info:
(800)