Beacon Appeals and Grievance Management Software
Beacon Appeals Manager (BAM) is a highly configurable and automated solution, designed by health plan compliance and operational experts. Our appeal and grievance management software 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
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 on our appeal and grievance management software.
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 as an appeal and grievance management software 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.