Preisser Solutions · for Freedom Claims Management
01
Preisser Solutions×Freedom Claims Management

What we could build together.

A walkthrough of the platforms and automations we would build with Freedom Claims: new revenue for your hospitals, and engines that take the paperwork off your team.

Prepared for Hadley Gillum · November 2026 · Concept walkthrough
Hospital membershipWho earns whatQuotes for agentsRisk intelligenceEnrollmentClaimsStop-lossHRA administrationEmployer reportingLead generation
01 · Hospital membershipConcept

Give every hospital a membership program.

A QR code in the lobby. A neighbor scans it, joins in under a minute with Apple Pay, and their member card lands in their Wallet. We build and run the platform. The hospital owns the relationship.

  • Scan, join and pay in under a minute
  • Kansas membership agreement signed in-app (K.S.A. 65-4978)
  • The hospital sees every member and every dollar, live
Concept A QR at the front desk. A member in under a minute.
Your hospital.Monthlymembership.
Care close to home
Scan to join.Primary care, telehealth and three plans from $35/mo
Care that knows your name.
9:41
Your hospital.Monthlymembership.
Care close to home
Scan to join.Primary care, telehealth and three plans from $35/mo
Care that knows your name.
membership.prairievalleyhealth
SLO-MOVIDEOPHOTOPORTRAIT
Membership
Prairie Valley Hospital · Great Bend
BasicPlusFamily
What’s included
Primary care visitsUnlimited
TelehealthSame day
Labs & imagingMember price
Monthly$59.00$35.00
Membership agreement under K.S.A. 65-4978. Cancel anytime.
Subscribe with Pay
Pay
Visa Debit•••• 4821
Basic Membership$35.00 monthly · starts today
Pay Prairie Valley
Hospital$35.00
Pay with Face ID
Face ID
Done
Cancel AddAdded
Prairie Valley StatusActive
PlanBasic care
MemberJordan EllisMember IDPVH-0012847
SinceNov 2026Primary careUnlimitedRenewsDec 4
PVH-0012847
Show at check-in. Updates automatically.
membership.prairievalleyhealth/admin
MembershipPrairie Valley Hospital · Great Bend, KS
Live
Members
1,284
+48 this week
Monthly revenue
$44,940
Recurring monthly
Via lobby QR
32
This week
Renewals
96%
Members by county
HospitalMemberNew
Jordan E. · new
JEJordan Ellis · MemberJoined at lobby QR · now+$35/mo
11Scans the QRLobby sign
22Picks a planBasic, $35
33Apple PayFace ID
44Wallet passMember card
55Hospital sees itLive dashboard
02 · Who earns whatConcept

Every member pays everyone.

Each member pays the hospital every month. A flat platform fee per member is split between Freedom Claims and Preisser Solutions. The hospital keeps the rest.

  • The hospital: recurring revenue and loyal patients
  • Freedom Claims: a share of every member, every month
  • Preisser Solutions: runs, secures and insures the platform

Hospital membership program · who makes money

Concept

Each member pays the hospital $35 a month. $5 goes to Freedom Claims, $5 to Preisser Solutions, and the hospital keeps $25.

One member's $35 payment, every monthwhere every dollar goes

The hospital

per member, per month$25
per year at 1,000 members$300,000

Delivers the care and owns the member relationship

Freedom Claims

per member, per month$5
per year at 1,000 members$60,000

Brings the hospitals and runs the program with them

Preisser Solutions

per member, per month$5
per year at 1,000 members$60,000

Builds and runs the platform: hosting, security, bot & spam protection, data insurance, support

1,000
10010,000
$35
$25$150
Platform fee $10 / member / month, split $5 / $5
Illustrative — terms to be agreed
03 · QuotesConcept

An agent sends an employer. Get a ready-to-present quote.

An insurance agent emails over a small employer's employee list. Freedom Claims gets back a polished, branded quote with plan options and monthly prices per employee, ready to present, in about a minute.

  • Any employee list, any format
  • Monthly prices per employee, by plan
  • Your brand, reimagined (concept shown)
Concept An agent's email in. A ready-to-present quote back.
KR
Kelsey Ruiz<kelsey@ruizinsurance.com>
9:14 AM
To: quotes@freedomclaims.com
Quote request: Great Bend Feed & Seed (48 employees)

Hi team,

Great Bend Feed & Seed just got their renewal at +14% and the owner wants options. Employee list and renewal letter attached. Could you quote it by Friday?

Thanks, Kelsey
Ruiz Insurance Agency, Great Bend

XLS
GBFS_employees.xlsx24 KB
PDF
Renewal_letter_2027.pdf318 KB
XGBFS_employees.xlsxRead-only
D6fx
ABCDEFGHI
1Emp IDLastFirstDOBSexZIPTierStatusHire Date
2GB1001HartmanDale3/4/811981-03-04M67530EEActive6/2/2014
3GB1002VossMarlene1975-11-22femaleF67530familyFAMActive2009-03-16
4GB1003BrandtTessa1988-07-09F675367530Emp+SpouseESActive11/30/2019
5GB1004OkaforLen12-1-19691969-12-01M67544EEActive1/15/2007
6GB1005LindqvistRaeblank1986-04-12F67530EEActive2021-08-02
7GB1006NunezCal1992-02-14MaleM67526EE+KidsECActive04/19/2022
8GB1007PaulsenGwen1984-06-30F67567EECOBRA2013-10-07
9… 41 more employees
CensusNotesReady
PDFRenewal_letter_2027.pdf1 / 2
MIDLAND MUTUAL HEALTH · RENEWAL NOTICEGroup GB-30482 · Great Bend Feed & Seed · Oct 21, 2026Monthly premium $27,405 → $31,242 effective 01/01/2027
+14%
48 employees · 8 fixes · 1 birth date missing
Freedom Claims Quotes<quotes@freedomclaims.com>
SendSending… Delivered 10:42 AM
To: Kelsey Ruiz <kelsey@ruizinsurance.com>
Re: Great Bend Feed & Seed · one birth date missing
Freedom Claims

Hi Kelsey,

Thanks for the list. One birth date is missing. Send it and we will finish the quote.

Missing
Birth date · Employee 05
Reply with birth date

Freedom Claims Quoting Team

Great Bend, KS · Sent securely · Privacy · Unsubscribe
KR
Kelsey Ruiz replied · 10:51 AM“Employee 05 was born April 12, 1986.”
Added
GBFS_Quote_2027.pdf1 / 3  ·  100%
Freedom Claims
PLAN YEAR 2027
Prepared for Ruiz Insurance Agency

Great Bend Feed & Seed

2027 Health Plan Quote

48 employees3 optionsLevel-funded
Proposal FCM-Q-27-0482
Effective Jan 1, 2027
ConceptPage 1 of 3
GBFS_Quote_2027.pdf2 / 3  ·  100%
Freedom ClaimsProposal FCM-Q-27-0482
Rate proposal, per employee

48 eligible · Effective January 1, 2027

PEPM rateper monthPrairie PPO 1000Plains HSA 3000Heartland Copay 500
Employee only$468$412$512
Emp + Spouse$936$824$1,024
Emp + Child(ren)$834$734$912
Family$1,212$1,067$1,326
Total a month$27,942$24,598$30,568
Plan design summary
Deductible$1,000$3,000$500
Out-of-pocket$4,500$6,000$3,500
Office visit$30After ded.$20

Based on 38 EE · 3 ES · 3 EC · 4 FAM. Stop-loss included. Valid 60 days. Concept · illustrative.

Effective 01/01/2027Page 2 of 3
GBFS_Quote_2027.pdf3 / 3  ·  100%
Freedom ClaimsQ-27-0482
Saves vs. renewal
$3,300a month

That is $39,600 a year under the +14% renewal.

Renewal$31,242
Heartland Copay 500$30,568
Prairie PPO 1000$27,942
Plains HSA 3000$24,598
Today $27,405
Ready to presentStop-loss included · valid 60 days
Great Bend Feed & SeedPage 3 of 3
Freedom Claims Quotes<quotes@freedomclaims.com>
SendSending… Delivered 10:58 AM
To: Kelsey Ruiz <kelsey@ruizinsurance.com>
Your quote for Great Bend Feed & Seed is ready
Freedom Claims

Hi Kelsey,

Thanks for the birth date. The quote is attached: three plan options, ready to present.

Recommended
Prairie PPO 1000
Monthly total
$27,942 for all 48 employees
Vs. renewal
Saves about $3,300 a month · $39,600 a year
View quote
PDF
GBFS_Quote_2027.pdf1.4 MB

Freedom Claims Quoting Team

Freedom Claims Management · Great Bend, KS · Sent securely · Privacy
  1. 1ReceivesAgent's email + list
  2. 2Reads48 employees
  3. 3Checks1 birth date missing
  4. 4Sends back / FilesAsks agent · builds quote
  5. 5ConfirmsQuote sent to agent
04 · Risk intelligenceConcept

Know every group's risk before you take it on.

When a group comes over, the engine reads its whole history and hands your team a 30-second underwriting pre-read: trend, high-cost claimants, data gaps, and the stop-loss structure to quote.

  • Built on the submission-intake engine we already run in insurance
  • High-cost claimants and laser candidates surfaced
  • Plan-document and stop-loss gaps caught before day one
Group takeover · risk intelligenceConcept · fictional data
The old administrator sends the group's historyWe read 36 months of claimsWe find the riskWe ask for the 2 missing monthsYour underwriter gets a 30-second pre-read
Files received · read
  • XLSX
    claims_history_2023-26.xlsx
    18.7 MB36 months · 41,382 claims
  • CSV
    eligibility_census.csv
    412 KB512 employees · 1,146 lives
  • PDF
    plan_document.pdf
    3.4 MB88 pages · 214 provisions
  • PDF
    stop-loss_contract.pdf
    1.2 MB$60K specific · 12/12
  • PDF
    large_claim_report.pdf
    640 KB4 claimants over $50K
30-second underwriting pre-read
Sunflower USD 499 · 1,146 covered lives · takeover, effective 7/1/2026
AnalyzingReady in 28 sec
Claims by policy month · data qualityclaims_history_2023-26.xlsx
2 months missing
Jul 2023Jul 2024Jul 2025Jun 2026
Mature 24 mo Developing 9 Immature 3 Data hole 2 A missing month is not a clean month.
Claims vs expected
107%of expected
$548 vs $512 PMPM expected
Credibility-weighted $535 · 70%
3-year trend
+7.9%per year
PY24 $471PY25 $509PY26 $548
Risk score
/ 100
Moderate-high
High-cost claimants · 4 > $50K$75K specific
Claimant 1$318K
Claimant 3$286K
Claimant 2$142K
Claimant 4$64K
Claimant 3 ongoing oncology → laser candidate
Claims lag · IBNRmonths to pay →
$531K
IBNR: care already given, not yet billed
Paid so far: Jun 55%, May 78%, Apr 90%
Plan document vs stop-loss contract · 2 gapsuninsured if they happen
!Bariatric surgery: stop-loss excludes it; the plan covers it.Plan p.41 · Contract §4.2
!Transplants: plan pays at any facility; stop-loss only at a Center of Excellence.Plan p.47 · Contract §6.1
Step 5 · RecommendationDraft for the underwriter · every figure links to its source
Specific deductible$75K Aggregate attachment125% Contract12/15 Laser recommendedClaimant 3
  1. 1ReceivesHistory, old admin
  2. 2ReadsClaims by month
  3. 3ChecksTrend, HCCs, gaps
  4. 4Sends back / FilesAsks for 2 missing months
  5. 5ConfirmsPre-read to underwriter
05 · EnrollmentConcept

Paperwork that finishes itself.

An enrollment form arrives. The engine reads it and checks it against the plan. Perfect? It's in the system and everyone gets a confirmation. Wrong or conflicting? It goes straight back with exactly what to fix.

  • Received, read and checked automatically
  • Sent back with plain-English fixes
  • Filed and confirmed, with no chasing by your staff
FC Enrollment inbox AI at work Concept 7/7 Confirms

An HR office emails a scanned form. Nobody has to retype it.

The AI reads the handwriting, field by field.

Every field is checked against the plan's rules.

Two things are wrong, so it writes HR a clear note in plain English.

HR sends the fix, and the AI checks it again.

The record is updated and filed. Nobody re-keys anything.

HR and the employee are both told, automatically.

Inboxenroll@freedomclaims.example

Prairie Valley Hospital9:20 AM

New hire: Luis Ortega

Reading Perfectfiling now Filed · confirmed

Perfect first read · 38 sec

Sunflower USD 499 HR9:12 AM10:41 AM

Change form: Evan WhitfieldRe: Change form: Evan Whitfield

New Reading 2 problems Sent back Fix came in Filing Filed · confirmed

Barton County8:47 AM

Address change: K. Baines

Filed · confirmed

Cedar Bluff Co-op8:31 AM

Ending coverage: R. Unruh

Filed · confirmed

Today: 3 in · 2 filed Today: 4 in · 2 filed · 2 reading Today: 4 in · 3 filed · 1 with HR Today: 4 in · 4 filed · 0 retyped

Change form: Evan Whitfield (add spouse and child)

Eligibility system · Sunflower USD 499

Confirmations sent

Just in Reading the form 2 problems Waiting on HR Re-checked Updated 10:41 AM Filed
DP

Dana Pruitt <benefits@usd499.example>

To: enroll@freedomclaims.example

Wed, Nov 4 · 9:12 AM

Change form: Evan Whitfield (add spouse and child)

Hi team,

Attached is Evan Whitfield's change form. Evan got married and is adding his spouse, Jamie, and his stepdaughter, Riley, to his medical plan.

Thanks,
Dana Pruitt
HR Benefits, Sunflower USD 499
620-555-0142 · benefits@usd499.example

Whitfield_change_form.pdfPDF · Scanned, 1 page · 412 KB
DP Dana PruittAttached is Evan Whitfield's change form. 9:12 AM
FC

Freedom Claims Enrollment <enroll@freedomclaims.example>

To: Dana Pruitt <benefits@usd499.example>

Composing…Sending…Delivered 9:13 AM

2 things to fix on Evan Whitfield's enrollment form

Freedom ClaimsEnrollment

Hi Dana,

Thanks for Evan's form. Before we can add Jamie and Riley, we need two things:

  1. 1Jamie's date of birth is blank in the dependents section.
  2. 2The marriage was Sep 18, 47 days ago. The plan allows 30, so we need your OK to accept a late add.
EmployeeEvan Whitfield · ID 44817FormChange form, received 9:12 AM

Upload corrected formOne-time secure link · expires in 7 days

Thank you,
Freedom Claims Enrollment Team

Freedom Claims · 1200 Main St, Great Bend, KS 67530
This message was sent securely. Privacy · Unsubscribe

Written from the formChecked against the plan rules

FC Freedom Claims EnrollmentTwo things before we can add Jamie and Riley. 9:13 AM
DP

Dana Pruitt <benefits@usd499.example>

To: enroll@freedomclaims.example

Wed, Nov 4 · 10:41 AM

Re: 2 things to fix on Evan Whitfield's enrollment form

Corrected form attached, Jamie's birthday is 06/11/1990. I approve the late add for Evan; the district allows HR exceptions for a marriage.

Dana Pruitt · HR Benefits, Sunflower USD 499

Whitfield_change_form_v2.pdfPDF · 1 page · 398 KB
Late_add_approval.pdfPDF · Signed by HR · 96 KB

Read and checked again

Spouse DOB 06/11/1990HR approval on fileAll 6 checks pass
SUNFLOWER USD 499 · HUMAN RESOURCES
Employee Enrollment / Change Form
Employee Health Plan · Group 0499 · Administered by Freedom Claims
499
New enrollmentChange to existing coverageTermination
1Employee information
First nameEvan1
Last nameWhitfield
Employee ID44817
SSN (last 4)XXX-XX-6023
Date of birth03/14/1988
Home address412 Sycamore Ln, Salina KS 67401
Hire date08/12/2014
2Coverage electionMedical · check one
ReasonMarriageBirth / adoptionLoss of coverageDivorce
EE onlyEE + SpouseEE + Child(ren)FamilyWaive2
Date of event (marriage)09/18/2026347 days ago
Coverage to start12/01/20266
3Dependents to addAttach proof of relationship
NameRelationshipDate of birthSSN last 4
Jamie WhitfieldSpouseMissing44174
Riley WhitfieldStepchild04/02/201992815
4Other coverage / coordination of benefits

Is anyone listed above covered under another group health plan?

YesNo
5Signature and date

I certify the information is true and complete. Changes take effect only as the plan allows.

Employee signature
7
11/02/2026
Date signed
For HR use · received 11/2/26 · D.P.RECEIVED
FCM-ENR-01 Rev. 01/2026Return to HR within 30 days of the eventPage 1 of 1

Whitfield_change_form.pdfReading the handwritingChecking the plan rules

What it readWhitfield_change_form.pdf

1EmployeeEvan Whitfield · ID 44817
2ChangeEmployee only → Family
3ReasonMarriage on Sep 18, 2026
4SpouseJamie Whitfield · birth date blank
5ChildRiley Whitfield · Apr 2, 2019
6StartsDec 1, 2026
7SignedEvan Whitfield · Nov 2, 2026

Every field as written, handwriting included. Nobody typed it in.

Checked against the plan

Evan is active and eligibleOn the district's payroll roster
Family tier is offeredPlan year 2026
Riley qualifies as a childUnder 26
Signed and datedBy the employee, Nov 2
Spouse date of birth missingNeeded to add Jamie to the plan
Marriage was 47 days agoPlan window is 30 days: needs HR approval

VerdictSend back · 2 items

EW

Evan Whitfield

Member FCM-0499-44817 · Sunflower USD 499

Record updated
CoverageEmployee onlyFamily Members
Evan Whitfieldemployee
ADDEDJamie Whitfieldspouse · 06/11/1990
ADDEDRiley Whitfieldchild · 04/02/2019
StartsDec 1, 2026 Late addApproved by HR on Nov 4 · on file
Carrier eligibility file queuedGoes out with tonight's file, no one re-keys itQueued
ID cards ordered3 cards, mailed to the Whitfield homeOrdered
Confirmations draftedTo HR and to EvanNext
FC

Freedom Claims Enrollment <enroll@freedomclaims.example>

To: Dana Pruitt <benefits@usd499.example>

Composing…Sending…Delivered 10:42 AM

Done: Evan Whitfield is on Family coverage from Dec 1

Freedom ClaimsEnrollment

Hi Dana,

Evan's change is filed. Jamie and Riley are added, your late-add approval is on file and ID cards are in the mail. Nothing else is needed from you.

EmployeeEvan WhitfieldCoverageFamily, from Dec 1

Freedom Claims Enrollment Team

Great Bend, KS · Sent securely · Privacy · Unsubscribe
FC

Freedom Claims Enrollment <enroll@freedomclaims.example>

To: Evan Whitfield <evan.whitfield@usd499.example>

Composing…Sending…Delivered 10:42 AM

You're covered: Family coverage starts Dec 1

Freedom ClaimsEnrollment

Hi Evan,

You, Jamie and Riley are covered starting Dec 1. New ID cards for all three of you are on the way.

Member IDFCM-0499-44817PlanFamily medical

View your ID cards

Freedom Claims Enrollment Team

Great Bend, KS · Sent securely · Privacy · Unsubscribe
1perfect, filed on first read
1sent back, fixed in one reply
0fields typed by staff
  1. 1ReceivesForm from HR
  2. 2ReadsWhat it read
  3. 3Checks2 problems found
  4. 4Sends back / FilesFix list → corrected
  5. 5ConfirmsHR + employee told
06 · ClaimsConcept

From the provider's claim to the member's answer.

A clinic sends Freedom Claims the bill for a visit. The engine checks the member's coverage, works out who pays what, pays the clinic, and emails the member exactly what they owe with a link to pay. Anything unusual goes back or goes to a person.

  • Coverage and network price checked
  • Member emailed what they owe, with a pay link
  • Clinic paid and told the patient balance
Freedom Claims · claims desk Concept

1A clinic faxes Freedom Claims the claim for Jordan’s visit

2We read the faxed form, so nobody types it in

3We check Jordan’s coverage

4Here’s who pays what

5We email Jordan what’s owed, and tell the clinic it’s paid

NOV-04-2026 09:41FROM: GT PLAINS CLINIC 6205550142P.001/001
HEALTH INSURANCE CLAIM FORMAPPROVED BY NATIONAL UNIFORM CLAIM COMMITTEE (NUCC) 02/12
PICA
1. MEDICARE  MEDICAID  TRICARE  CHAMPVA  GROUP HEALTH PLAN  FECA  OTHER☐☐☐☐☒ GROUP☐☐CARRIER: FREEDOM CLAIMS MGMT · PO BOX 1365 GREAT BEND KS
2. PATIENT'S NAME (Last, First, MI)MEADOWS, JORDAN A
3. BIRTH DATE · SEX03 12 1988  M
1a. INSURED'S I.D. NUMBERBCE0482917
4. INSURED'S NAMEMEADOWS, JORDAN A
6. PATIENT RELATIONSHIP☒ SELF
12./13. SIGNATURESSIGNATURE ON FILE
11. INSURED'S GROUP NUMBERBARTON CO 0417
21. DIAGNOSIS OR NATURE OF ILLNESS  ICD Ind. 0A. R05.9   B. R53.83
24A. DATE OF SVCB. POSD. CPT/HCPCSE. DX PTRF. $ CHARGESJ. RENDERING NPI
10 14 261199214AB212001487650231
10 14 261180053B118001487650231
10 14 261171046A82001487650231
25. FEDERAL TAX I.D.48-1928374
28. TOTAL CHARGE$ 41200
33. BILLING PROVIDER INFO & PH #GREAT PLAINS FAMILY CLINIC
1919 MAIN ST, GREAT BEND KS
NPI 1295847301
26. PATIENT'S ACCOUNT NO.GPF-118274
31. SIGNATURE OF PHYSICIANR. HALE MD 10/14/26
32. SERVICE FACILITYSAME AS 33
NUCC Instruction Manual available at: www.nucc.org  ·  FORM CMS-1500 (02-12)
New claim received By fax from Great Plains Family Clinic, one office visit

What we read

  • PatientJordan Meadows
  • Health planBarton County employees
  • VisitOct 14, 2026
  • Services99214 · 80053 · 71046
  • Billed$412.00
JM
Jordan MeadowsBarton County employee plan · member since 2021
Jordan is coveredActive on the plan on the day of the visit
The clinic is in-networkSo the plan’s discounted price applies
Yearly deductible already metFrom here the plan pays most of the cost
EOB-CL-26-004812.pdf1 / 1
EXPLANATION OF BENEFITSFreedom Claims, administrator for Barton County Employee Health Plan
THIS IS
NOT A BILL
MemberJordan A Meadows
Member ID · GroupBCE0482917 · 0417
Claim numberCL-26-004812
Date of service · Processed10/14/2026 · 11/04/2026
ProviderGreat Plains Family Clinic
Network statusIn-network (PPO)
ServiceBilledPlan discountAllowedPlan paidYou owe
99214Office visit212.0070.90141.10121.1020.00
80053Lab panel118.0040.7077.3066.1011.20
71046Chest X-ray82.0032.0050.0043.007.00
Remark codes

45 Charge is above the plan’s contracted rate; the clinic writes it off.

2 Coinsurance is your share of the allowed amount.

PR-1 $0.00: yearly deductible already met.

Billed by clinic$412.00
Plan discount (network)−$143.60
Allowed amount$268.40
Deductible (met)$0.00
Coinsurance$38.20
Plan paid$230.20
YOU OWE$38.20
Not a bill. Pay only the statement from your provider or use the link in your email. Questions: Member Services 620-555-0100. Appeals within 180 days. FCM-EOB-01 Rev. 03/2026
Remittance-835-CL-26-004812.pdf1 / 1
REMITTANCE ADVICE835 payment summary · Freedom Claims Payments
Payee
Great Plains Family Clinic
Payee NPI · TIN
1295847301 · 48-1928374
Payer
Barton County Employee Health Plan
Payment date
11/04/2026 · ACH credit
EFT trace #
TRN*1*7730418226
Claim numberDOSBilledPaid
CL-26-00481210/14/26412.00230.20
GroupCARCReasonAmount
CO45Contract rate143.60
PR1Deductible0.00
PR2Coinsurance38.20
Total adjustments181.80
Paid to you by EFT$230.20
Billed 412.00 − CO-45 143.60 − PR-2 38.20 = 230.20. PR amounts are the patient’s responsibility. Reassociation per ASC X12 835 (005010X221A1).
Freedom Claims
<claims@freedomclaims.example>
Sending…Delivered 10:42 AM
To: Jordan Meadows
You owe $38.20 for your Oct 14 visit
Freedom Claims

Hi Jordan,

Your plan covered most of your visit. Here’s the rest.

  • Clinic billed$412.00
  • Network discount−$143.60
  • Your plan paid−$230.20
  • You owe$38.20
Pay $38.20Pay later / set up a plan
PDF
EOB-CL-26-004812.pdf · 41 KB

Freedom Claims Member Services

Great Bend, KS 67530 · Sent securely · Privacy · Unsubscribe
Freedom Claims Payments
<payments@freedomclaims.example>
Sending…Delivered 10:42 AM
To: Great Plains Family Clinic billing
Payment of $230.20 sent for Jordan Meadows · Patient balance $38.20
Freedom Claims

Hi Great Plains billing team,

We paid this claim today by direct deposit.

  • ClaimCL-26-004812
  • Paid to you$230.20
  • Patient balance$38.20
835
Remittance-835-CL-26-004812.pdf38 KB

Freedom Claims Provider Payments

Great Bend, KS 67530 · Sent securely · Privacy · Unsubscribe
Needs a personBigger claims get a second look: a $48,210 hospital stay from Prairie Valley Hospital is with a nurse reviewer, and we’ve asked for the itemized bill. Nothing is denied while we wait.
  1. 1ReceivesClinic’s bill
  2. 2ReadsPatient + $412
  3. 3ChecksJordan covered
  4. 4Sends back / FilesWho pays what
  5. 5ConfirmsMember + clinic
07 · Stop-lossConcept

Never miss a stop-loss dollar.

Every claimant tracked against the specific deductible, lasers and the aggregate attachment point, across every provider and Rx. When a claim crosses the line, the reimbursement packet builds itself and is filed on time.

  • Specific and aggregate tracked daily
  • Large-claim notices sent at 50%
  • Packets filed well before the paid deadline
Barton CountyStop-loss contract 12/15Plan month 9 of 12
Stop-loss radar
Concept · illustrative numbers
Every paid claim is added to each person's totalClaimant A crossed the $50,000 lineThe packet builds itselfFiled with the stop-loss carrierThe carrier confirmed it
Specific stop-loss · top claimantsEvery paid claim, totaled per person
Specific deductible $50KSpecific $50K Aggregating specific corridor $25KCorridor $25K
Claimant A
$98,640
Claimant B
Laser $125K
$88,200
Claimant C
$41,200
Claimant D
$28,900
Claimant E
$19,300
$0$50K$75K$100K$125K$150K
Claimant A reimbursable: $98,640 − $50,000 − $25,000 =$23,640
Aggregate stop-lossWhole group · 42 employees
%
of YTD aggregate attachment
Expected claims (100%)
  • Attachment125% · $1,184 PEPM
  • Paid YTD$367K of $437K
Meets Kansas K.A.R. 40-1-49
BRE-SL-120_BartonCounty_ClaimantA.pdf1 / 7100%Auto-built
234567
BLUESTEM REStop-Loss Claims · Overland Park, KS
FORM BRE-SL-120
Rev. 06/2025
SPECIFIC REIMBURSEMENT REQUEST / CLAIM NOTICESubmit within the claim filing period stated in the policy. Attach supporting documents.
1. Policyholder & policy
1a. POLICYHOLDERBarton County, Kansas
1b. PLAN ADMINISTRATOR (TPA)Freedom Claims Mgmt
1c. POLICY NO.BRE-SL-0417-26
1d. BASIS12/15
1e. CONTRACT PERIOD03/01/2026 - 02/28/2027
2. Claimant & diagnosis
2a. CLAIMANT ID0417-0003-01 (A)
2b. AGE · SEX · REL.52 · M · EE
2c. FIRST INCURRED05/19/2026
2d. PRIMARY DIAGNOSIS (ICD-10-CM)I21.4 NSTEMI; I25.10 CAD
2e. LARGE-CLAIM NOTICE SENT2026-08-11
3. Amounts (USD)
A. Paid to date, incurred 03/01/26 through 11/02/2698,640.00
B. Specific deductible50,000.00
C. Aggregating specific corridor25,000.00
D. AMOUNT REQUESTED (A − B − C)23,640.00
4. Attachments
  • Claim history (837 ledger)
  • Itemized bills (UB-04 / 1500)
  • Proof of payment (835 / EOB)
  • Eligibility verification
  • Plan document, pp. 41-44
  • Disclosure statement
5. AUTHORIZED SIGNATUREKim Albers
TITLEStop-loss Analyst
DATE11/04/26
CARRIER USE ONLY: CLAIM NO. 
DATE RECEIVED 
FORM BRE-SL-120 (Rev. 06/2025)Page 1 of 7
Mail · SentSending…Delivered 10:42 AM
FC
Freedom Claims Stop-loss Desk
<stoploss@freedomclaims.com>
To: Bluestem Re claims <claims@bluestemre.com>
Today, 10:42 AM
Specific reimbursement request · Barton County · Claimant A · $23,640
Freedom Claims

Hi Bluestem Re claims team,

Claimant A passed the $50,000 specific deductible and the $25,000 aggregating corridor under Barton County's contract. The signed request and supporting packet are attached.

GroupBarton CountyClaimantClaimant A
Paid to date$98,640Requested$23,640
Ded. + corridor$50K + $25KDeadline days left
BRE-SL-120_BartonCounty_ClaimantA.pdf 2.6 MB · 7 pp.Claims ledger 837.csv 184 KB
Freedom Claims · Great Bend, KS · Sent securely · Privacy · Unsubscribe
Bluestem Re: Received, in review10:43 AM
  1. 1ReceivesEvery paid claim
  2. 2ReadsClaimant totals
  3. 3ChecksSpecific + aggregate
  4. 4Sends back / FilesPacket filed
  5. 5ConfirmsCarrier acknowledged
08 · HRA administrationConcept

Every reimbursement checked and paid.

An HRA is money an employer sets aside to pay back employees' medical costs, and Freedom Claims runs it for them. An employee sends in a receipt; the engine checks it against that employer's rules, asks for anything missing, pays what's eligible and updates the employer's report.

  • Each employer's HRA rules applied
  • Substantiation requested automatically
  • Employer funding reports always current
FC
HRA administration deskFreedom Claims · reimbursements for employer-funded HRAs
AI at work Concept
?HRA = money an employer sets aside to pay back employees' medical costs. Freedom Claims runs it for them.
Dana sends in a pharmacy receipt
1

A reimbursement request arrives in the HRA queue

HRA-1041Reimbursement request9:14 AM · employee portal
Freedom ClaimsEmployee portal · HRA Request sent$428.59 Receipt + EOB attached
We will email you View my HRA
Submitted by the employee
Employer
Barton County
Plan
Barton County HRA, deductible-only
Employee
Dana Whitfield · ID BC-2207
Requested
$428.59
IMG_2817.jpgReceipt photo · 2.4 MB
EOB_PVH_1014.pdfPDF · 118 KB
We read the receipt and her insurer's statement
2

It reads the receipt and the EOB, line by line

What it readphoto + PDF
Rx atorvastatin 20mg$27.60
OTC vitamin D3$14.99
EOB, to deductible$386.00
We check it against Barton County's rules
3

It checks every line against Barton County's plan

Barton County HRA plan, 2026 · deductible-only. Reimburses only what the medical plan applied to the deductible (§3.1).
MRI, Prairie Valley HospitalApplied to the deductible on the EOB. Eligible under §3.1.
$386.00ELIGIBLE
Atorvastatin 20mg, prescriptionRx applied to the plan deductible. Eligible under §3.1.
$27.60ELIGIBLE
EOB matches the claim on fileClaim BC-26-08812: same patient, date, provider and amount.
MatchVERIFIED
Vitamin D3 gummiesOver the counter, never applied to a deductible. Not eligible, §3.1.
$14.99NOT ELIGIBLE
Dana's 2026 HRAThis request −$413.60
Annual HRA $1,500.00Remaining $1,086.40
Marcus forgot a document, so we ask for it
4

The next request is missing a document, so it is sent back

!
HRA-1042 · Marcus Hale · Barton County · $96.40Receipt from Prairie Valley Clinic, 10/22. No EOB attached, so it cannot be paid yet.
FC
HRA Desk, Freedom Claims
<hra@freedomclaims.example>
To: Marcus Hale
Wed, Nov 4
Sending…Delivered ✓ 9:15 AM
We need one more document for HRA-1042
Freedom Claims

Hi Marcus, we have your $96.40 request from your 10/22 visit to Prairie Valley Clinic. Before we can pay it, we need the Explanation of Benefits (EOB) for that visit. It shows what your plan applied to your deductible.

Upload EOBYour request stays open.
Freedom Claims HRA Team
Freedom Claims Management · 1400 Kansas Ave, Great Bend, KS 67530 · Sent securely. Privacy · Unsubscribe

On hold, not denied. When the EOB arrives it is read and checked again automatically.

Dana's money is approved
5

Dana's request is paid, and the employer's funding is updated

Reimbursement approved
$413.60
Employee
Dana Whitfield · BC-2207
Request
HRA-1041
Paid by
ACH, Friday Nov 6
To
Checking ••7390
Not paid
$14.99, not eligible
What happened
Approved by the plan rules$413.60 of $428.59, 9:15 AM
Added to Friday's ACH batchDirect deposit, Nov 6
Barton County funding updated+$413.60 on this week's report
HRA balance updated$1,086.40 left for 2026
Dana and Barton County both hear back
6

The employee and the employer both get confirmation

FC
HRA Desk, Freedom Claims
<hra@freedomclaims.example>
To: Dana Whitfield
Wed, Nov 4
Sending…Delivered ✓ 9:16 AM
$413.60 is on its way
Freedom Claims

Hi Dana, your HRA request HRA-1041 is approved. The money goes to checking ••7390 on Friday, Nov 6.

Approved$413.60
Not covered (vitamin D3, OTC)$14.99
HRA balance left for 2026$1,086.40
View my HRAFreedom Claims HRA Team
Freedom Claims Management · 1400 Kansas Ave, Great Bend, KS 67530 · Sent securely. Privacy · Unsubscribe
Added to Barton County's funding reportBy employee ID only, no medical details
To fund Fri 11/06$1,257.40$1,671.00
  1. 1ReceivesRequest + receipt
  2. 2ReadsReceipt + EOB lines
  3. 3ChecksBarton County HRA rules
  4. 4Sends back / FilesEOB asked · $413.60 paid
  5. 5ConfirmsEmployee + employer report
09 · Employer reportingConcept

Every group's report, ready on day one.

For your employer groups, the county clerk or the school business manager: a clear monthly report on claims versus expected, funding and what's driving cost. They can ask a question and get the answer, and Freedom Claims leadership sees the whole book the same way.

  • For every employer group, every month
  • Written in plain English
  • Ask anything about the plan
NOV1Nov 1 · 6:00 AM
42 groups · reports ready
Concept
PDFBarton-County_Plan-Report_2026-10.pdf1 / 6− 100% +
Freedom ClaimsThird-party administrator
Great Bend, KSGroup 10482 · Report FCM-MPR-01
Period 10/01/26 – 10/31/26
Monthly plan report Self-funded · 42 enrolled

Barton County · October 2026

Claims paid vs expected Paid Expected
Funding balance
$41.2K
118% of target
Top cost drivers share of paid claims, YTD
Pharmacy31%
Outpatient imaging18%
Maternity12%

Claims ran 6% under expected through October, helped by a quiet summer for hospital stays. Pharmacy is still the biggest cost, so the plan is watching specialty drug fills closely heading into year-end.

Generated Nov 1, 6:00 AM · de-identified · illustrative figures
Confidential: plan sponsor use only. No individual member data.Page 1 of 6
10 · Lead generationConcept

From word of mouth to a pipeline.

Today every new group comes from a referral or a phone call. The same engine that runs Hays Academy's marketing tracks every ad, search and referral QR back to the lead it produced. It routes each employer to your team with the next step, and cuts the spend that isn't working.

  • Every lead traced to the ad, search or referral that sent it
  • Routed to the right person with the next step
  • Wasted ad spend found and cut every week
FC Lead engine Concept Sample lead, not real client data
Google search
fFacebook
inLinkedIn
ChatGPT
Agent QR
BC
Pawnee County employer · 38 employeesSearched self-funded health plan Kansas
New lead
AdSelf-funded plansGoogle search ad
PageSelf-funded health plansfreedomclaims.example
FormRequest a quoteSent 10:31 AM

Source: Google · ‘self-funded health plan Kansas’

How good a fit
Group size38 employees
CountyPawnee, in our area
Current plan renewsJan 1
86Good fit
Routed to
HG
Hadley G.VP of Sales
Next stepAsk for the employee list to quote
HG

Hadley Gillum <hadley@freedomclaims.example>

To: Pat Reyes <pat@bartonvalleysupply.example>

Composing…Sending…Delivered 10:42 AM

Next step on your quote: your employee list

Freedom ClaimsGroup health plans

Hi Pat,

Thanks for asking about a self-funded health plan. To build your quote, we only need one thing from you.

NeededYour employee list (38 people)Plan renewsJan 1
Get a quote Employee_list_template.xlsx14 KB

Hadley Gillum, Freedom Claims

Great Bend, KS · Sent securely · Privacy · Unsubscribe
This week, in plain EnglishWeek of Nov 2
Wasted spend found: health insurance jobsPeople looking for jobs, not a health plan
$64 Paused
Where this month’s leads came from
Google search11
Facebook5
Agent QR4
ChatGPT2
LinkedIn1

This month

23leads
9good fits
4quotes sent
  1. 1ArrivesGoogle search
  2. 2TracesAd, page, form
  3. 3QualifiesGood fit
  4. 4RoutesTo Hadley G.
  5. 5Follows upEmail delivered
Preisser Solutions×Freedom Claims Management

Start small, grow with results.

A monthly subscription that grows as the results do. No big upfront project. Each phase pays for the next.

Phase 1Weeks 1–3

Membership portal

  • Members join and pay online for $35 a month
  • Every member and visit tracked for the hospital
  • Lobby QR display and a first hospital live

The secure foundation everything else plugs into

Phase 2After the first of the year

Claims engine

  • EDI feeds and faxed claims read automatically
  • Each member's benefits applied, spending tracked
  • Enrollment and HRA journeys

Claims without the manual keying

Phase 3Next

Underwriting and quotes

  • Quotes built from any employee list, not spreadsheets
  • Risk pre-read and stop-loss radar
  • Employer reporting portal

Faster quotes, safer groups

Phase 4Ongoing

Grow the brand

  • A new website and brand
  • Lead generation that tracks every lead to its source
  • An engine that tunes the ad spend every week

Inbound leads, not only word of mouth

Start with Phase 1 → See what's already live ↗