Acclaris has spent a decade refining its software and processes for maximum utilization and high-volume capacity. Behind the scenes lies a hyper-efficient, globally distributed health claims process that is fast, accurate and virtually paperless.
Our system processes millions of financial transactions each year, underlying over $1 billion in annual reimbursements. The combination of pipeline monitoring, work queue balancing and an advanced adjudication system assures that health claims and other payments are processed on a timely, accurate and cost-effective basis.
Intake/Receiving
Acclaris images every claim form and supporting document received, whether through image upload, high-volume fax servers or incoming mail processing function. Within hours, images are indexed and linked to the account, and the member is notified by email.
Processing/Adjudication
Our process combines a series of system checks and experienced manual processing to assess adherence to regulations and plan rules (such as eligibility status, duplicate checking, funds availability, stacking protocols, etc.). As a result, Acclaris achieves the industry’s fastest, most accurate and cost-effective health claims turnaround.
Notification
Integral to the platform, electronic notifications are provided at multiple checkpoints including: claim receipt; processing completion (approval or denial); substantiation requests; and disbursement.
Disbursement
Acclaris supports payment disbursements via ACH, check and payroll. Payment batches are run on a daily basis, although disbursement frequency is client-configurable. Funding and payment reconciliation services are also provided as part of our suite of offerings.