ACM Information

ACM Business Solutions delivers specialized technology consulting services to healthcare organizations with a focus on claims processing, benefits administration, and EDI integration. With over 25 years of experience, and deep expertise in platforms like EZ-CAP, our team helps health plans, MSOs, IPAs, TPAs, ACO, and other providers modernize systems, improve operational efficiency, and meet complex regulatory requirements. Example of services • Developing custom software and utilities • EDI Services on all X12 transactions 837P, 837I, 835, 834, 278, 270/271, 276/277 • Creating Fee Schedules and Benefits from Health Plan Evidence of coverage files • Analyzing and creating of auto adjudication rules for auto certification • Developing websites and portals • Developing reports from simple to complex for compliance, ODAG, CMS • Support in HEDIS and NCQA certification • Support in Medicare, Medicaid benefits administration from eligibility inloads to referrals to claims processing to payment processing • Support in developing value-based pricing models • Migrating data from legacy systems to newer systems, and new client onboarding into current applications • Archiving data for system performance and additional security • Creating applications in Care Management, our though our own Care Management application • Provider credentialing • Creating Crystal, Power BI, reports, dashboards and APIs • Building Data Warehouse based on Client specific requirements • Nightly monitoring and reporting of critical applications and processes preparing data for the next morning What sets ACM apart is our unmatched domain expertise, rapid response times, and commitment to real-time, knowledgeable client support. We ensure timely, direct support, no weeks-long delays or ticket queues. We offer flexible engagement models to meet your evolving technology and resource needs. 🔹 Experience Matters! Let ACM Business Solutions be your partner in driving healthcare technology forward.