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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:
The Facets Accumulator Synchronization solution is pre-mapped to the Facets core administration platform, allowing rapid implementation and smooth integration.
Real-time delivery of claims and customer service items, reducing bottlenecks and automating work.
Near real-time accumulator synchronization between Facets and third-party vendors.
Supports the administration of flexible spending accounts, health reimbursement arrangements, and health savings accounts.
Real-time ITS solutions for claims processing and member liability estimation for BCBS plans.
Data publishing and web services that extend and integrate with the Facets system in real-time with third-party applications.
Administer and reimburse long- and short-term disability benefits
Supports HMO products for capitated entities to share financial risk and claims, along with UM processing responsibilities.
Increase efficiency with dental-based claims processing and adjudication.
A comprehensive native robot marketplace to accelerate implementation, operational efficiency, scalability, and savings.