24

years of industry experience
 

executing timely and accurate payments to people in need.

Secure Systems, Sleepful Nights

All of our systems are run in our secure infrastructure that is safe and ultra-secure. We continuously monitor and validate the status of all systems owned and operated by PAI which ensures your data is safe and secure.

How Do We Do It?

Our Secret is the Synthesis of Systems into Payment Processes with Experienced People

The synthesis of systems, processes and people ensure that we consistently meet or exceed service level requirements and always provide exceptional customer service. We have an outstanding client retention record which is a direct result of our exceptional and dedicated account management and customer service teams. Our staff has the experience and knowledge to anticipate program needs and works independently assuring clients that programs are being administered accurately and professionally and allowing our clients to focus on their own responsibilities.


Our Synthesized Systems Approach Allows for Customized Solutions to Fit Your Needs

A shared vision throughout PAI is evidenced by our process improvement and outstanding service outcomes starting at the point of first contact where we listen to our clients describe their needs and objectives. We create a customized solution that may be our system, your system or a combination. By implementing efficient processes, robust customized reporting and innovative systems that meet our client’s unique objectives, we make agile and mighty PAI, with nearly 30 years of tenured staff experience, the right choice.

What Are Our Primary Systems?

PAI’s Primary Proprietary Systems and the typical administrative functions they perform are:
 

CARE4

Groundbreaking, state-of-the-art web-based payment and tracking system. Direct, seamless, and secure, bi-directional interfaces to client agency data and documents. Customizable and scalable. Functionality includes:

  • Insurance premiums
  • Medical out of pocket premiums
  • Cross Validation logic between insurance and out of pocket premiums
  • Processing CMS data for Medicare Part D
  • System generated letters
  • Tracking APTC, refund
  • Clearinghouse interface
  • Tracking inbound/outbound calls
  • Reporting

 

See if PAI can CARE4 your systems and leave you without a care in the world.

Contact us today!

SPARCS

Medicare payment system with direct seamless interfaces to CMS to securely administer Medicare payments including:

  • COB response lookup tool
  • Report manager
  • Member eligibility lookup
  • Application request log
  • Tax modeler
  • Document management

 

See if our SPARCS System ignites your interest.

Contact us today!

REINSURANCE

Leveraged Administrative Reporting Systems that can be customized to fit any eligibility criteria and all generally accepted payment parameters including:

  • Easy Lift Reporting of readily available data
  • Flexible Eligibility Criteria like Diagnoses, Risk Classes, Specific Dollar limits or Dollar Corridor Ranges
  • Secure File Transfer Protocols
  • Automatic Server Polling
  • Automatic validation and editing of all reported data
  • Pro-Forma Chart of Reinsurance Accounts

 

See if you can assume our Simple, Safe and
Cost-Effective Reinsurance program meets your needs.

Contact us today!

HYBRID SOLUTIONS

Integrating leading edge technology resources with our proprietary systems for a seamless hybrid solution. Customizable with cost in mind, without cutting corners.

  • Foresite
  • Tekcetera
  • Microsoft Dynamics
  • SMC Partners
  • SphereGen
  • MRx
  • Schroth Consulting

 

See how PAI can take the struggle of an off the shelf, or standalone
system and work with you to link your system with ours.

Contact Us Today!

 

Frequently Asked Questions

Response: Our infrastructure is hosted at a large industry leading facility that is SOC2, SOC3, HIPAA and PCI certified. All data storage is performed at this site. We provide secure SFTP file transfer for all data to protect PHI.
Response: PAI Takes precautions to protect your information both offline and online. Throughout the year various testing is performed by a qualified 3rd party to validate that the security measures implemented are effective.
Response: Annual reviews of all security policies and procedures are conducted and enhancements (if needed) are added to keep the security of all information up to date with current best practices. Quarterly assessments are performed to validate the status of all systems owned and operated by Pool Administrators Inc. meet or exceed expected levels of security.
Response: Any sensitive information is always encrypted and stored using state-of-the-art encryption and best practices. Only employees who need the information to perform a specific job (for example, billing or customer service) are granted access to personally identifiable information.
  • “PAI’s commitment to effectively managing all aspects of our account relationship is evident from the first line insurance benefit consultants through to their financial and management support team members.”

    Executive Director, State Health Insurance Plan
  • “The PAI staff has been highly professional, knowledgeable and helpful. They perform their administrative functions on a timely and accurate basis and always keep the Board of Directors informed.”

    Board Chair, State Legislated Entity
  • “PAI takes initiative, problem solve and provide quality work in a timely manner. As I manage multiple programs and contracts, their ability to keep me informed while working successfully and independently has been invaluable.”

    Medical Administration Manager, State Department of Social Services