Claim Agent integrates Institutional and Professional claims into one Claims Management System for personal computers running Windows operating systems. Claim Agent was built from the ground up to edit, submit and manage both HIPAA standard claim formats to all payers. It is the first truly new claim scrubber, submission, and management software of the century. Claim Agent has been in production at client sites since September 2002.

Claim Agent is HIPAA compliant with respect to Transactions and Code Sets and Technical Safeguards.

Institutional claims are displayed on the user's screen in a facsimile of the UB04 paper claim form. This format provides the user with a familiar visual representation of an institutional claim.

Professional claims are displayed on the user's screen in a facsimile of the Form 1500 (Revised) paper claim form. This format provides the user with a familiar visual representation of a professional claim.

Claim may be entered (Imported) to the database from claim print files, transmission formats ANSI 837 and NSF 6.0, customer specific file formats, or from the keyboard.

Electronic claims are packaged for delivery (Exported) to payers in ANSI 837 4010A1.

Direct submission of claims to Medicare and other large payers that accept direct data interchange.

Clearinghouse claims are submitted under our vendor agreements. No additional charges for participating payer claims.

Paper claims may be individually or batch printed to preprinted forms, or Claim Agent will print the background form.

Claim data may be modified using a mouse and a standard keyboard commands.

Extensive data checks are performed to include date sensitive ICD-9 and HCPC Level 1 & 2 codes. Thousands of payer specific cross checks assure submission of clean claims.

Claim access and change logs provide management with a complete history of who viewed a claim and changes made by user and password.

Claim storage is virtually unlimited. Claims saved to the database may be retrieved at any time for review, re-submission or printing.

Help system provides user with system usage and maintenance information. All data and all claim scrubber edits are documented. No paper manuals.

Reports (Import, Export, Error Analysis) are stored in Acrobat Reader or as text files.

Data Base links to spreadsheet and database tools allow for information analysis.

Internet Updates assure Users that their software meets current needs in a timely and efficient manner.