EFFECTIVELY MANAGE CLAIMS ACCUMULATOR DATA

Near real-time accumulator synchronization between core medical and ancillary benefit partners.

Accumulators are the method of precisely collecting and calculating total claim dollar values against plan deductibles and benefit limits. Managing claims accumulator data in a timely fashion can be both difficult and costly to a health plan. Accumulators that are shared between core medical and third party benefit partners such as pharmacy, mental health, dental and vision can be especially vulnerable to out-of-sync data. If not managed properly, it is easy for plans to overpay.

The Facets Accumulator Synchronization solution solves these problems. Built on advanced technology including a real-time service interface, Facets Accumulator Synchronization provides near real-time synchronization of accumulator data updates between Facets and third party ancillary benefit vendors. This feature can:

• Reduce the time required to handle accumulators
• Improve the accuracy of accumulator data
• Ensure that deductible and benefit limits are properly applied
• Avert out-of-balance situations with latency between processing and updating
• Help clients support the Affordable Care Act mandate around maximum OOP, and lower administrative costs
• Improve data accuracy and allow for efficient data processing
• Provide the scalability and flexibility to grow with your business

The Facets Accumulator Synchronization solution is pre-mapped to the Facets core administration platform, allowing rapid implementation and smooth integration.