Capabilities and Features
The following is a list of some of the features and capabilities of ProClaim:
| » Web-based system, requires zero deployment. Interfaces with all processing systems including PowerMHS and Facets. |
| » Queue based distribution. First in, first out. |
| » Grouping of queues into "goals", user-configurable, to meet check run deadlines. Goals are assigned to examiners systematically. |
| » Assignment of claims to examiners based on skill sets. |
| » Assigned goals crossed with skill sets present the mathematically optimal claim to an examiner's desktop to minimize interest penalties. |
| » Real-time feedback of examiner performance and inventory changes every five minutes. |
| » Quickly make changes to your entire claims department with the click of a button when an emergency arises. |
| » Provides complete audit trail of all activity within the system, everything time stamped with the users who operated on the claim. |
| » Sharing of work across departments, or geographic locations at the touch of a button. Multiple departments can share the same queue. |
| » View inventory and performance with "Tree-based" reports, in the context of your organization's hierarchy. Monitor subordinates progress. |
| » Processing alerts attach to qualifying claims so that important alerts are presented to examiner alongside the claim. Lessens examiner burden. |
| » Every aspect of ProClaim is configurable, from the ground-up. The unique SQL based configuration model eliminates the need for expensive programmers. |
| » ProClaim performs its daily inventorying and distribution activities automatically. Relieves this burden traditionally performed by supervisor. |
| » Deliver desk procedures to the desktop for the suspension codes that exist on the claim. |
| » ProClaim works with multiple processing systems. Provides a single, consolidated view to monitor suspended claims activity across the enterprise. |
| » Ability to view claim activity in "non-claims" areas such as Enrollment or Provider services |
| » Easily segregate claims out of claim population when necessary to prevent examiners from receiving them. |
