ProtoCLAIMS, in essence, offers FREE CLAIMS (access to multiple payers who offer direct access into their claims systems) and commercial claims submission with ONE SINGLE PUSH-BUTTON ACCESS without ever leaving ProtoMED.

Non-direct payers are automatically processed through a national clearinghouse. Claim status is automatically updated to reflect payer acceptance or rejection information and may be reviewed 24/7 from any Internet connection.

ProtoCLAIMS processing represents a composite of several processing steps, some at the user's desktop, others at the ProtoWEB host site - all executed with the PUSH OF ONE BUTTON from a client's local ProtoMED.

You need only press the "SUBMIT" button to invoke the most sophisticated electronic claims in the market regardless of price. ProtoMED brings the Internet and your direct-connect payors together to provide for free claims processing without multiple dial-up sessions. Our pre-edit traps problem claims and allows for changes within the submission process. The claims monitor (shown above) displays progress and appraises the user of abnormal activity. ECS history files are maintained for HELP DESK support and management history. Payor reports are automatically retrieved upon each submission. TCD and Payor reports are stored in ProtoMED for future use. Claims can be recalled and re-submitted by date of service, or by batch date. The simplicity of push-button electronic claims saves hours of staff time and sanity each week.

ROUTING CLAIMS: Once the claims are transmitted into the ProtoCLAIMS routing center, each claim is read to determine if ProtoMED can establish a DIRECT LINK into the insurance payer's system. If it is determined that four of the ten different insurance companies processed in the current claims transmission can go directly to the payer without a clearinghouse, the ProtoCLAIMS processor will create four separate contact sessions and route the claims WITHOUT A CLEARINGHOUSE. Since the claims are transmitted directly to the payer - these claims will be processed FREE OF CHARGE for the practice.

ProtoMED provides for typical claims management tools (insurance summary & detail reporting, recalled bills, recalled batch), but it also ships with one of the most sophisticated claims management tools available our claims manager product. Updated PAYER STATUS is automatically associated with each line item, thereby giving users INSTANT ACCESS TO REJECTED CLAIMS. The Claims Manager allows for online access to insurance claims, patient claims, or all claims. Once displayed, claims may be instantly sorted by last bill date, patient name, insurance name, amount owed, and other combinations enabling claims to be worked visually in an online format. Click on a claim and view unlimited billing history complete with bill date, form type, and bill source. Click again and go directly to the charge ledger to view the line item in context with the entire record. Or, you may re-bill the claim with one click!