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About ABS

Third party Administration. First Class Results.

For more than three decades, ABS has been providing third party administration (TPA) services to client groups across the country and on a limited international basis.

The ABS portfolio of services and capabilities includes selffunded medical, prescription drug, dental, vision, disability, HRA, FSA, COBRA, MEWA and benefit fund administration services; cost containment and online enrollment; and medical management services, including utilization management, disease management, complex case and behavioral health management, wellness and prevention programs, medical bill review, managed care systems and managed care consultation.

We develop benefit programs that suit our clients' needs—from simple, straightforward medical plan administration to multi-tier programs involving numerous networks and complex fee structures, we are capable of providing custom-tailored, best-inclass solutions.

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 Committed to Your Health.

In 2015, ABS along with its affiliated companies Ascension Care Management Holdings, Ltd. (formerly U.S. Health Holdings) and US Health and Life Insurance Company, was acquired by Ascension Care Management (ACM), a wholly owned subsidiary of Ascension, the largest nonprofit healthcare system.    

ACM is a population health services company that provides a range of healthcare solutions to members, providers, payers and employers that improve the health of communities and enhance the overall healthcare experience for providers and individuals, while stabilizing or lower costs.

The ACM family of companies includes care management services delivered through its Care and Network Management Division and comprehensive risk management services through its Risk Services Division. It also offers a range of third-party administration services and health insurance solutions through its Automated Benefits Services and US Health and Life Insurance Company divisions.

Given the ACM range of services, we strive to create a seamless healthcare experience for members, providers, payers and healthcare leaders by improving access to and removing complexity from the delivery of healthcare.

ACM serves 1.3 million members across the nation and manages over 18,000 providers through our clinically integrated networks of providers. Beyond traditional population health management solutions, ACM offers additional expertise in claims management, care coordination, risk management and employee safety strategies.

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. ABS performance is guaranteed to meet or exceed stated benchmarks below.

Turnkey Solutions.

ABS provides a turnkey solution for TPA services offered– from facilitating a seamless transition of records predating our contract to providing numerous ongoing valueadds.

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, members and providers facilitating 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

Professional Staffing and 24/7 Service

A staff of more than 200 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 Customer Service services portals for members, groups and providers.

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.