Success Story: High-Volume Administration

Overview

A large national financial services and HR outsourcing provider reengineered the administration of consumer-driven healthcare and other accounts for more than 200,000 eligible participants.

Client Challenge

When its incumbent benefits administration vendors consistently failed to meet accuracy and timeliness commitments, a large national financial services and HR outsourcing provider sought a comprehensive solution to account administration.  With more than 200,000 participants, the firm’s portfolio spanned diverse accounts, from traditional CDH vehicles such as FSAs and HRAs to more than 20 other employee reimbursement programs including supplemental dependent care, commuter, tuition, adoption, retiree medical, and wellness.

With a large number of Fortune 500 accounts, it was critical that our client’s own customers had a high degree of comfort with the selected system, particularly in terms of functionality, flexibility, scalability and privacy.  Additionally, with increasing cost pressure in the benefits administration space, the company sought to introduce improved economics into its business model.

The firm undertook a rigorous selection process, which involved significant IT, financial and risk management due diligence to not only meet its own standards, but also those of its marquee clients.

The Acclaris Solution

Acclaris was awarded an initial five-year initial contract based on the strength of its technology, implementation flexibility, global delivery model and credentials such as SAS-70 Type II certification.  Over a period of seven months, Acclaris partnered with the client on a phased large-scale implementation comprised of more than 40 individual project plans.

Acclaris delivered a full outsourced solution that met the client’s requirement of a single platform which manages all accounts in one location, with a consistent experience for the submission, management and reimbursement of claims.  Key features include:

  • Self-service access to submit, manage and track claims throughout the reimbursement cycle
  • Easy-to-use participant and employer web portals
  • Multi-channel (mail, fax and on-line) claims intake and integrated processing with multiple (check, ACH, payroll, and debit card) disbursement options
  • Dedicated participant care services with complete transparency and metrics.

Recently, the company further expanded functionality with the transition to Acclaris’ newly-enhanced technology platform, which includes:

Integrated Health Debit Card
More than 40,000 client account holders use Acclaris’ IIAS-compliant health benefit card, which incorporates an industry-leading rate of auto-substantiation.

Online Claims Submission
Streamlining the submissions process, members submit claims on-line and can upload receipts directly.  “Pay my provider” functionality is also imbedded within the claims submission process.

Advanced IVR System
In addition to standard on-line web features, an intuitive Interactive Voice Response (IVR) system allows members alternative real-time access to answer their most common questions about claim status and account balance.

With respect to the launch of these enhanced features, Acclaris was able to anticipate and address client transition elements with no degradation in service as the enhancements were rolled out.

Results

Acclaris’ integrated solution enabled our client to address key strategic goals surrounding its account based health plans and related offerings, including:

  • Cost improvements: from enhanced self-service functionality to strengthened operations and a global “virtual” shared service center
  • Scalability:  to support aggressive marketing of account based health plans with the ability to handle increasing complexity with consistent service and multiple participant support channels
  • Privacy: to protect the secure healthcare information of its participant base
  • Flexibility: to extend the fundamental “building blocks” of a reimbursement system into a flexible, seamless customer experience.

A senior leader on the client’s benefit outsourcing team explained why Acclaris is a good business partner: “They work collaboratively, strategically and creatively to get the best result for the client. The Acclaris team is a pleasure to work with.”

In the client’s annual vendor review, Acclaris received an excellent rating, reflecting consistent commitment to meeting service level agreements.  Acclaris received especially high rankings for the following attributes:

  • Account team value
  • Support team communication
  • Senior team accessibility
  • Ease of use
  • Reliability of products & services
  • Web application availability.

Acclaris’ platform serves as an integral component of the client’s benefits offering, with competitive prices and ease-of-use that promotes adoption among both group employers and participants.