Improves handling of health plan data
ANN ARBOR, Mich.–(BUSINESS WIRE)–The United States Patent and Trademark Office granted a patent to AccumTech for a computer system and database design which processes and matches misidentified health plan member names with misidentified health provider claims.
The Ann Arbor-based firm assists health plans, pharmacy benefit managers (PBMs) and third-party administrators with translating and integrating claims data between a variety of health providers and vendors. As a key service, AccumTech tallies co-insurance, co-pays and deductibles for individual and family members enrolled in health plans.
Andrew Madonna, AccumTech Vice President, said, “Most automated claim problems do not occur with dollar figures, numbers and math. Enrollment data, especially the nuanced coding that differs between systems, drives most of the problems with tracking benefit expenditures.”
For example, Blue Cross Blue Shield of Michigan and a PBM may use different member ID numbers or their records contain different derivations of the same name. AccumTech’s patented method quickly matches the member’s personal information – even though it varies between systems – with the corresponding records in another system so that benefit costs and totals can be accurately updated and tallied.
“Our ClaimGen system and Enrollment Engine act like a universal translator,” said Madonna. “It lets us coordinate and communicate all the data into each organization’s native computer ‘language’ and member identification scheme.”
Gary Gavin, Blue Cross Blue Shield of Michigan Vice President, Autos, National & Key Accounts, said, “After partnering with AccumTech in 2018, our team did not have to implement time consuming new procedures or big programing changes which improves customer service. We quickly experienced an improvement with claims reconciliation. In addition, our members and health partners have higher satisfaction resulting from shorter lead times for vendor transitions with superior outcomes.”
Patent Number 11,217,346 covers AccumTech’s computer system design and methods of integrating health plan member eligibility and payor claims databases with both systems using their native layouts, business logic and other processing specifications.
AccumTech was founded in 2014 as a spin-off company from Part D Advisors, Inc. (Livonia, MI), the nation’s largest full-service Retiree Drug Subsidy administrator, where a process was developed to match prescription drug claims with misidentified enrollment data. AccumTech is certified by American Institute of CPAs — System & Organization Controls and is ranked as one of the Coolest Places to Work by Crain’s Detroit Business. Visit www.accumtech.com.
Contacts
Alex Cooper, 248-398-2667 / acooper@accumtech.com