Login

About ABS

Third party Administration. 

First Class Results.

Automated Benefit Services is one of the nation’s leading providers of third party administration (TPA) services, offering world-class capabilities, while remaining committed to delivering service with a personal, customer-centric focus– our telephones are answered by live operators, we invite employers and members to visit us in our offices, and our definition of success is measured by each individual member's positive experience.

ABS services approximately 625,000 lives, and processes more than 3.2 million claims for member clients with a total value exceeding $831 million annually.

A Family of Companies for a Strong Foundation.

ABS is a subsidiary of U.S. Health Holdings, Ltd., parent company to multiple  entities  with complimentary missions. ABS provides administrative services for the commonly-owned insurance carrier US Health and Life Insurance Company (USHL), insurer of tens of thousands of lives across the nation; USHL, in turn, provides excess loss insurance to ABS self-funded groups. ABS Managed Care Administrators (ABSMCA) is another subsidiary that provides care and disease management and wellness programs for ABS clients, USHL members, and external groups.

Documented Excellence

Numerous annual internal and external audits are performed by state and federal government agencies, clients and CPAs, independent firms and the ABS audit team. 

Year after year, ABS ranks favorably among its competition in both operational and financial performance.

Click on Operations Performance Chart
to see image at full-size.

Major Networks and Excess Loss Carriers.

ABS groups have the ability to select from the nation’s leading excess loss insurance carriers, including Aran Underwriters/Gerber and American Fidelity, HCC Life, Optum/Unimerica, Munich Re/American Alternative, Symetra, IHC/Standard Security, AIG/National Union, Northwind/Transamerica, MLB Re/Standard Life, Sun Life, and Stop Loss Insurance Services. The most popular Preferred Provider Organization networks are also available– Cofinity, HAP, Trilogy, Sagamore, HFN, FirstHealth, MMO, Cigna and PHCS, among others.

Professional Staffing and 24/7 Service

A staff of more than 170 professionals deliver documented excellence in enrollment and billing, claims adjudication and administration, client services and support, and customer communications.

Members and groups have access to a dedicated client services team and 24/7/365 service via online and electronic support– including a fax recall automated fax back system, electronic ID cards, online enrollment processing, and comprehensive web-based secure services portals for members, groups, providers and agents.

 

ABS Nationwide Presence
ABS provides custom benefit administration
to employers and groups nationwide—
from single-location companies employing hundreds
to multi-state organizations with employees
numbering in the thousands.

ABS provides custom benefit administration services to employers and groups nationwide—from single-location companies employing hundreds to multi-state organizations with employees numbering in the thousands.

 

Our Portfolio and Reach.

ABS provides some of the largest and most widely-known organizations across the nation and across the world with benefit solutions and services including:

  • Self-Funded Medical, Rx, Dental and Vision
  • HRA Administration
  • FSA Administration
  • COBRA Administration
  • Case Management and Utilization Review
  • Cost Containment
  • Online Enrollment
  • Benefit Fund Administration
  • Medicare Part-D Administration
  • HDHP Coordination with PBMs
  • Custom Benefit Solutions
  • MEWA Administration
  • Back-Room TPA Services (for insurance carriers, ACOs)

Above
ABS Office Locations
Birmingham and Sterling Heights, MI

Turnkey Solutions.

ABS provides a turnkey solution for TPA services offered– from facilitating a seamless transition of records pre-dating our contract to providing numerous ongoing value-adds. Although we tailor solutions to meet unique needs, our clients all universally receive:

  • The ABS proprietary cost containment system, Smart Claims, which targets savings in provider up-coding and unbundling, subrogation opportunities, alternative network savings, hospital credit balances, inaccurate billing and fraud
  • A dedicated client services team which ensures client compliance, provides plan reporting, assists in enrollment and employee meetings, handles group paperwork and amendments, and acts as liaison on client claim issues
  • Shared or dedicated customer support staffing tailored to client needs and expectations
  • Fully-integrated data systems with real-time updates between claims, customer service, billing, eligibility and enrollment, authorizations and managed care services
  • Web-based secure services portals for groups, agents and members providing 24/7 access to coverage details, enrollment data, provider searches, EOB lookups, and financial inquiries for administrators
  • Coordination of banking arrangements including account establishment and reconciliation to meet client needs
  • Run-in and run-out periods to meet client needs
  • Electronic recording, auditing and archiving of customer service calls
  • Disaster recovery/ business continuation programs guaranteeing minimal business interruption and immediate data restoration.
  • Customized plan reporting and communications
  • Established confidentiality policies and procedures

SmartClaims Savings Reports 
document money saved by ABS groups in categories including upcoding, network savings, provider bill audits, and hospital credit balances, among others, during the preceding quarter

Click on SmartClaims Savings Report 
to see image at full-size.