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.
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
Deliver insights without IT support with our reporting tool
Call attention to any of your special cases with flags
Secure and manage each piece of correspondence for future audits
Keep up with due dates through status alerts and notifications
Ensure accurate case classifications with our tools such as The Wizard
Configure BAM to meet regulatory and operational requirements
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.
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.