Healthcare technology and operations
ACM Business Solutions helps health plans, MSOs, IPAs, TPAs, and related organizations improve operations through technology consulting, software development, EZ-CAP support and optimization, workflow automation, EDI, analytics, and scalable BPO services. Our work is primarily consulting and service based, with products introduced where they can reduce manual effort, improve efficiency and reduce cost. ACM services are available across multiple systems and platforms, within and outside of healthcare.
Established in 2004. U.S.-based leadership with a global delivery organization supporting healthcare technology, software development, claims operations, EDI, analytics, QA, and BPO.
What we do
We provide strategic technology leadership, system optimization, implementation, and modernization grounded in healthcare and IT experience. We first look for ways to improve configuration, automate workflows, and reduce errors. When the work calls for additional capacity, our delivery team can scale to meet the need.
Strategic technology leadership, system optimization, implementation, and modernization for healthcare administrative systems.
Direct access to analysts and developers for production issues, configuration changes, and ongoing optimization. The aim is timely, effective solutions rather than a long ticket queue.
200+ resources delivering healthcare operations, with hundreds of thousands of claims processed annually and a 99.5% accuracy SLA. BPO staff work with ACM technology and analytics teams to reduce manual intervention where possible.
More than 25 years developing commercial products and custom solutions. Microsoft Gold certified development. EDI Validator and analytics are available when they fit the work.
EZ-CAP practice
ACM Business Solutions’ leadership and technical teams bring decades of experience developing, implementing, supporting, and optimizing healthcare administrative systems, including the EZ-CAP family of products. From 2005 to 2014, ACM principals owned and led EZ-CAP development and still have many of the original technical staff as team members. Today, ACM is an independent consulting and services firm; it is not the current software publisher.
We support organizations running EZ-CAP with:
EZ-CAP is a third-party platform. ACM provides independent consulting, support, and complementary tools for organizations that use it.
IT support services
ACM gives clients timely access to the analysts and developers doing the work, helping to resolve issues without a long ticket queue. Support covers production problems, configuration changes, and planned updates to applications already in use.
Troubleshoot production issues involving claims, benefits, letters, security roles, and related configuration.
Assess patches and upgrades against each client’s benefit plans, configurations, and workflows before deployment.
Clients may also reserve senior team capacity each month for support and planned improvements. Unused hours can be applied to documentation, rule cleanup, or training.
BPO
ACM’s team of more than 200 supports claims, benefits, and other administrative operations, processing hundreds of thousands of claims annually under a 99.5% accuracy SLA. BPO specialists work alongside ACM’s technology, analytics, and automation teams to improve processes, reduce manual effort, and measure results.
EDI, automation, and analytics
A rejected transaction is only one cost of an EDI problem. Poor data quality and recurring errors also create claims exceptions, research, and administrative work. ACM combines healthcare EDI expertise with integration, automation, and operations support. Its EDI Validator checks inbound and outbound X12 transactions so teams can identify issues before they move further through the workflow.
837P · 837I · 835 · 834 · 278 · 270/271 · 276/277
Industries
Manage claims inventory, improve auto adjudication and EDI quality, and align system configuration with Evidence of Coverage (EOC) requirements.
Support delegated operations, maintain provider data, manage workflows related to capitation, and produce reporting for health plan partners.
Handle growing transaction volumes with defined service levels and automation that limits the need to add staff at the same rate.
Implement or stabilize administrative platforms with experienced support that can scale as needs change.
Results
Figures taken from current ACM materials. Named client case studies can be added when approved.
99.5%
Hundreds of thousands of claims processed annually with BPO and QA on the same team that tunes the workflow.
200+
Functional, technical, BPO, and QA professionals supporting healthcare technology and operations.
2004
Founded as a technology consulting, software development, and BPO company. U.S.-based leadership, global delivery.
Insights
Administration
Claims and benefits administration, eligibility and enrollment, provider and fee schedule configuration, and auto adjudication optimization.
Systems
EZ-CAP support and optimization, EDI/X12 transaction processing, data migration and conversion, quality assurance, and testing.
Insight and capacity
Dashboards that track claims inventory, auto adjudication rates, pend reasons, aging, EDI performance, costs, and BPO results. Staff augmentation to meet changing workloads.
About ACM
Founded in 2004, ACM Business Solutions provides technology consulting, software development, and business process outsourcing. ACM combines U.S. based leadership with a global delivery team of more than 200 professionals supporting healthcare technology, claims operations, EDI, analytics, quality assurance, and related business functions.
Our teams use Agile, waterfall, or a hybrid approach based on the client’s needs and capacity. Every engagement starts with a practical question: What does success look like for this project?
Next step
Contact us about consulting, EZ-CAP support, application support, BPO, software, or EDI Validator. Tell us about your organization and what you would like to accomplish.
Longwood, Florida · ACMcontact@acmbs.com
Email our team to start a conversation.
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