ADMINISTRATIVE CONCEPTS, INC. Administrative Concepts, Inc. (ACI) was founded in 1995 to provide employee benefit administration to the employer community. Our company is based on the philosophy that each client be treated as our only client; our success is in the delivery of a customized service that meets the special need of each client.
LOCATION
Our office is in the Dallas suburb of Rockwall, Texas, a fifteen-minute drive east of Dallas. Rockwall is a growing community that has maintained a friendly, customer service attitude.
STAFF
ACI is committed to assuring clients that our staff members are both experienced and qualified for the services provided. Our current clients can confirm these assurances.
Our performance standards include claims payments within 15 days of receipt of the claim and a 24-hour response timeframe to telephone calls, facsimiles, or email. These performance standards require that the number of ACI employees be directly proportional to the needs of each client.
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Tim
Williams, President, has worked in the employee benefits business 25 years. He has been in the TPA business for 15 years.
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Carol Duffer, Claims Manager, has over 25 years experience in paying health care claims. She has been with ACI since inception. Carol supervises two specialists and claims pre-processor.
TECHNOLOGY
ACI believes the most efficient medium for the transmission and processing of data is electronic transfers. Every effort is made to maintain the most advanced adjudication and communication technology feasible.
Our AS400 system will process and store any and all data necessary to administer your plan accurately and promptly. The system produces standard reports that satisfy most needs and is flexible in producing ad hoc reports that may be occasionally needed or requested.
Data can be transmitted to the system by tape transfer, Internet download, e-mail or hard copy. Communications with ACI employees can be by telephone, fax, e-mail, or regular mail.
CLIENT BASE
ACI clients are large companies and small companies. Some have several thousand employees and some have less than 100. Our clients are trucking companies, law firms, and banks and manufacturing companies, surgical facilities and construction companies, oil companies, safety equipment companies and municipalities.
Each client has special demands due to their industry, their demographics, their risk tolerance, their size, their logistics, etc. Our services vary with each client according to their needs. Some only require payment of health care claims according to their plan document. Others need assistance in all facets of administering their employee benefit plans. This growing need inspired us to add Benefits Outsourcing Services to our service portfolio.
APPROACH
We encourage clients to visit with us to discuss their needs, requests and requirements and learn about our capabilities. We feel this is the first step in designing the services and the level of service that will meet the client needs.
Our objective is to provide a valuable service at a profitable, but fair, price. This is the formula for creating a long-term relationship that will benefit your employees and allow you to focus on the products and services you provide your customers. We look forward to demonstrating our capabilities to you in more detail. 24/7 ELIGIBILITY/INFORMATION LINE The Administrative Concepts, Inc. AS 400 eligibility system gives employees and employers access to important information 24 hours a day, 7 days a week, 365 days a year. The information is available via a toll free number and provides individual eligibility, benefits summary and claim status updates.
INDIVIDUAL ELIGIBILITY
Through the toll free phone call, doctor's offices, hospitals, and employees can obtain confirmation of coverage of an employee and eligible dependents. This access is free of answering machines; call holding and being passed from one phone line to another.
This toll free number is printed on the employee I.D. card Access to the information requires the employee social security number and employer plan number. The computer response
· Verifies coverage or indicates that the social security number can not be found;
· Identifies the type of benefit(s) currently effective
· And identifies the covered dependents.
The information provided on the eligibility line is most helpful to individuals when they require medical treatment during non-business hours. It is also a timesaving and efficient method for acquiring information during business hours.
BENEFIT DESIGN SUMMARY
This same toll free number provides access to a summary of benefits such as Managed Care Network membership, doctor office co-payments, deductibles, coinsurance, and plan maximums are included. These items, along with the above listed eligibility information, us usually all the information needed by a health care provided (doctor's office, hospital or facility) to accept the patient. Requests for this information can require a great deal of time of your Employee Benefits Manager. This system should free time for other duties.
CLAIM STATUS UPDATES
At times, employees and/or health care providers as for the status of claims payments. The Information Line can provide basic information on the receipts of a claim, the claim processed date and/or when the check was issued or mailed. Again, the social security number and plan number are required, along with the date of service and provider I.D. number. |