COALITION AMERICA LAUNCHES NEW PAPERLESS SOLUTION FOR RECEIVING AND PROCESSING HEALTH CARE CLAIMS - EDIPlus! Simplifies processing and reduces administrative costs
ATLANTA, Ga. - April 10, 2002

A new paperless solution that will significantly reduce administrative costs associated with receiving, repricing and processing health care claims has been introduced by Coalition America. The new system will also enhance the repricing and negotiation of claims through CAI’s vast number of PPO and provider relationships.

The new solution, called EDIPlus!, involves the use of scanning/OCR services to convert paper claims to EDI transactions, eliminating the need for paper handling by the payer. Once claims are scanned, they are submitted electronically by providers; both types of claims are then forwarded electronically to Coalition America for repricing.

"Using EDIPlus!, all claims from hospitals, physicians and ancillary providers will be delivered to the payor electronically," said Scott Smith, President, Coalition America. "Claims will be checked for eligibility before being routed to CAI for PPO repricing or negotiation."

According to Smith, CAI will then return the repriced claim back to the clearinghouse or OCR vendor for formatting into whatever layout the payor needs. The payor then accepts the repriced electronic claim into its adjudication system for processing. Both payors and providers will see several benefits with EDIPlus!

EDIPlus! complies with HIPAA regulations that require claims to be transmitted in a standard 837 file format. Further, there are no expensive adjudication system upgrades or file translator black boxes needed to achieve compliance.
Administrative costs associated with receiving, repricing, negotiating and processing claims are reduced through the elimination of paper claims.
Claims payment turnaround is improved and the system reduces or eliminates the number of claims pended for repricing.
EDIPlus! users can achieve even greater savings on out-of-network claims through access to the supplemental networks and negotiation services offered by CAI.
"We have subjected our clearinghouse and scanning/OCR vendors to extensive review," said Smith. "They have state-of-the-art technology and the highest quality standards for fail-safe claim accuracy, HIPAA compliance, performance guarantees and world-class service levels. CAI monitors performance between these vendors and our clients to ensure a high level of service, performance and satisfaction."

For more information about EDIPlus!, contact Coalition America, Inc., 4151 Ashford-Dunwoody Road, Suite 615, Atlanta, GA 30319, 404/459.7201 or sales@coalitionamerica.com.

About Coalition America

Coalition America, Inc. (CAI) is a leader in healthcare cost-containment and preferred provider organization (PPO) network management services emphasizing transactional excellence. The Atlanta-based healthcare technology company offers one source for PPO network access and administration, while assisting companies in controlling their medical healthcare expenses.

The range of services offered by CAI includes cost containment, primary PPO network integration and management, electronic data interchange (EDI), Internet repricing and data-entry options, and out-of-network bill negotiations on all claims. For more information on Coalition America, please visit www.coalitionamerica.com.

###