Our team's focus is on your success. Strategic technology leadership, system optimization, implementation and modernization backed by decades of healthcare and IT experience.
More than 25 years of experience developing commercial software products and custom software solutions for our clients. Microsoft Gold Certified development services.
Let ACM help to
OPERATE: BPO • Claims • Benefits • Eligibility • Administrative Services
OPTIMIZE: Workflow • Configuration • QA • Auto-Adjudication • Process Improvement
MODERNIZE: Automation • EDI • Analytics • Integration • Care Management • Custom Development
Claims, Benefits & Administrative Operations
Scalable Healthcare Operations ACM's 200+ resources delivering scalable healthcare operations with hundreds of thousands of claims processed annually and a 99.5% accuracy SLA. Our approach goes beyond adding resources. BPO professionals work alongside ACM's technology, analytics and automation teams to identify process improvements, reduce manual intervention, improve accuracy and deliver measurable operational results:
Claims • Benefits • Eligibility • Enrollment • Provider Operations • Credentialing • EDI • Data Management • QA
ACM brings decades of healthcare technology and operational experience to health plans, MSOs, IPAs, TPAs and other healthcare organizations.
Claims & Benefit Administration
EZ-CAP Support & Optimization
Eligibility & Enrollment
EDI / X12 Transaction Processing
Claims Auto-Adjudication Optimization
Provider & Fee Schedule Configuration
Care Management Solutions
Data Migration & Conversion
QA & Testing
Healthcare Analytics & Reporting
BPO & Staff Augmentation
Automate Healthcare Transactions. Identify Problems Earlier. Reduce Manual Work.
EDI problems don't end with a rejected transaction. Poor data quality and recurring transaction errors can create downstream claims exceptions, manual research, rework and unnecessary administrative costs.
ACM combines deep healthcare EDI expertise with automation, integration and operational experience to help organizations improve the quality and efficiency of healthcare transaction processing.
ACM's EDI Validator provides automated inbound and outbound validation of X12 healthcare transactions and helps organizations identify problems before they create additional downstream work.
Inbound & Outbound X12 Validation
TA1 • 999 • 277CA Tracking
CMS & Health Plan Business Rules
Duplicate & Error Detection
Claims & Encounter Validation
Reporting & Audit Trails
Turn Data Into Action
Healthcare organizations generate enormous amounts of operational, clinical and financial data. The challenge is transforming that data into information management can use to make timely decisions.
ACM designs analytics solutions that bring together information from claims, eligibility, providers, authorizations, encounters, EDI transactions and other systems to provide meaningful insight into operational and financial performance.
Dashboards can provide:
Claims inventory and processing trends
Auto-adjudication rates
Pend rates and reasons
Denial and rejection trends
Claims aging
Operational KPIs
BPO Performance
EDI Analytics
Cost Analysis
Executive Dashboards
ACM Business Solutions provides the bridge to move your organization across the divide to success!
Our leadership and technical teams bring decades of experience developing, implementing, supporting and optimizing healthcare administrative systems, including extensive experience with the EZ-CAP family of products
Whether your need is to maintain or update a legacy application, or to design and develop a new application, ACM provides the skills and experience to help make your project successful.
ACM Business Solutions team members are responsive and enjoy having direct communications. Our direct communication provides timely access to analysts and developers.
Stay out of the support ticket “abyss”. Instead, choose ACM to provide timely, effective solutions.
What if your technology and operations partner could give you more?ACM Business Solutions
- A value-added partner providing scalable BPO services that improve quality while reducing operational costs.
- A partner focused not only on performing the work, but on improving how the work gets done.
- Technology and healthcare solutions from a team with deep domain expertise.
- Access to 200+ functional, technical, BPO and QA professionals.
It's ok to allow yourself to take a moment, and say: "what if"?
Then contact ACM Business Solutions!
A frequent question we ask is: "What does success look like?"
Without the answer to this question how will you know you have reached your goal? That would be like beginning a road trip without a destination. It could be an interesting journey, but the results are not likely to be very successful or an efficient use of your time. A successful journey rarely happens by chance, it happens through thoughtful planning and timely communications.
ACM Business Solutions is your partner to a successful and well planned journey!
