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Beacon Appeals Manager

Beacon Appeals Manager (BAM) is a highly configurable and automated solution, designed by health plan compliance and operational experts. Our solution provides unparalleled control and transparency of cases from intake to review, ensuring complete compliance with Centers for Medicare & Medicaid Services (CMS). BAM enables you to effectively navigate oversight and management of Appeals and Grievances through healthcare reforms and regulatory updates.

Key Features

Streamline A&G Process

Whether you adopt our Best Practice Workflows or Customize BAM Configuration, you will enjoy the benefits of automation in intake, workflows and correspondence, reducing errors and improving turnaround times. BAM features a comprehensive library of regulatory reports including ODAG, CDAG and SARAG audit universes and CMS Quarterly reports, as well as scheduled KPI reports, user-friendly ad-hoc reports and dashboards providing transparency to inventory and performance.

Proven To Increase Star Ratings

Improve STAR Ratings and program audit scores and avoid NONCs (Notice of Non-Compliance) and CMPs (Civil Monetary Penalties) with built-in guardrails and best practice workflows.

Implementation In Record Time

Within 90 to 120 days on time and on budget, a completely configured system can be delivered to the client and includes training.

Discover The Perks

Comprehensive

Deliver insights without IT support with our reporting tool

Informed

Call attention to any of your special cases with flags

Organized

Secure and manage each piece of correspondence for future audits

Connected

Keep up with due dates through status alerts and notifications

Accurate

Ensure accurate case classifications with our tools such as The Wizard

Flexible

Configure BAM to meet regulatory and operational requirements

Add-Ons

Health Insurance Casework System (HICS)

Designed for commercial insurers to support the HICS process, this workflow provides the tracking and resolution of complaints and issues related to the health plan (e.g., identity verification, eligibility determinations, or appeals).

Complaint Tracking Module (CTM)

This module integrates with BAM and is designed for Medicare plans to manage and process complaints filed with CMS. CTM provides the tracking and resolution of complaints and issues rather than just a “get next” method.

Workbaskets

Automating the workflow to push and pull, Workbaskets auto assign cases (appeals or grievances) using a queuing logic method rather than the standard functionality in BAM.

Robotic Process Automation (RPA)

Also known as robotics or bots, this add-on feature imitates human actions, improving quality and reducing redundancy in business processes.

Ready To Get Started?

Experience the power of our innovative and trusted health plan solutions to meet regulatory requirements with confidence.
Request a Demo

Contact Us

  • 1-800-918-4120
  • info@beaconhcs.com
  • 17011 Beach Blvd, 12th Floor, Suite 1220, Huntington Beach, CA 92647

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© Beacon Healthcare Systems 2023

Additional Modules

Chris Mahoney

Chief Financial Officer
Chris Mahoney is a resourceful and results-driven senior finance executive with 25+ years of CFO-level experience leveraging keen financial expertise to create cost-efficient and sustainable financial results across both small and large corporate organizations. He consistently demonstrates the ability to critically evaluate and respond to rapidly evolving environments while identifying business-critical financial enhancements and developing proactive and actionable improvement initiatives. Chris also utilizes business acumen and cross-functional communication skills to routinely produce sophisticated solutions and align all financial activities with strategic business goals. Chris has acquired and integrated businesses, assisted in raising millions in $30mm equity and debt through private placements, transformed a business from a Perpetual to a SaaS model, assisted in growing businesses from $250mm to $1bn, and has implemented Project Accounting systems, cost, and management information systems.

Ken Stockman

Chief Executive Officer
Ken Stockman, Founder and Chief Executive Officer of Beacon Healthcare Systems, is a seasoned healthcare executive with strong Payer and Provider experience focused on bringing innovative solutions to Government program revenue management, operations, compliance, and risk adjustment. Ken was an early leader in the Medicare Advantage Risk Adjustment industry building a full suite of tools such as Full Enrollment, Member Reconciliation And Part D Platform to support the health plans’ initiatives in 2006 as co-founder and former CEO of Dynamic Healthcare Systems, Inc. His expertise in Risk Adjustment Strategy, Transaction Processing And Analytics positions him as a unique subject matter expert. Additionally, his experience in CMS Transaction Processing And Regulatory Requirements led to the successful design and implementation of industry-leading information systems.