Our state-of-the-art LuminX claims processing system allows us to process claims in a paperless fashion. Upon arrival at Allegiance, all claims, correspondence, and supporting documentation are scanned into LuminX. Information is immediately available to our claims examiners, customer service representatives, and provider service representatives. The LuminX system integrates claims processing with accounting, group billing and administration, and management reporting. Billing, accounting and management reporting databases are automatically updated from the claims processing system, making for a seamless system. In addition, we also operate a parallel LuminX system at a second location to provide our customers with the ideal disaster recovery system.
More About The LuminX Claims Processing System
Acclamation Systems, Inc. developed the automated benefit management system known as LuminX that Allegiance purchased and installed in 1999. LuminX is a fully automated claims adjudication system that combines integrated software design with the latest advanced technologies available in the computer industry. All aspects of our benefit administrative functions are fully integrated in the LuminX system, including actual claims processing, eligibility, customer service, accounting, group billing and claims administration. The system utilizes a combination of current computer hardware platforms that includes a high performance DEC (Compaq) Alpha Server running the Tru64 UNIX operating system that hosts the main claims processing programs and database. Document images are controlled by a Compaq ProLiant Server running MS Windows NT Server OS that utilizes the Ascent Image Server software system to manage images stored on a raid array hard disk system and on a Plasmon optical juke box.
Advanced features and benefits of the LuminX system include:
Expert System: LuminX contains an expert system module that automatically adjudicates all claims in a consistent and uniform manner, exactly as the most experienced claims examiners do. The module performs many more checks on each claim than is feasible for even the most diligent claims examiner. The expert system can be prompted, on a step-by-step basis, to display the logic used to adjudicate claims. This feature allows customer service and claims examiners to be highly responsive to inquiries regarding specific claims and is adaptable for our in-house training and testing purposes.
Document Imaging: LuminX's integrated imaging technology transforms claims processing from a highly paper intensive activity into a truly paperless function. All claims related documents are electronically stored and can be retrieved at any time for video display or laser printing. All images related to a claim are automatically retrieved whenever that claim is processed or reviewed subsequent to processing. Our customer service personnel have instant access to all images of documents relating to a participant and any of their claims.
High Performance System: LuminX has been developed to operate under the Windows and UNIX operating systems. Our primary hardware platform operates on a 100 Mbps state-of-the-art personal computer system network that provides access to all data, including non-archived document images, within seconds. The LuminX system will operate under any hardware platform supported by UNIX.
Auditing System: LuminX has an internal auditing system that facilitates auditing of all functions of the LuminX claims work flow, scanning, indexing and claims processing.
Laser Form and Check/EOB Printing: All forms, including magnetically encoded checks and the Explanation of Benefits (EOB) are laser printed on stock paper. The system has the ability to produce one check with multiple claims to a common provider and/or claimant.
Wide Range of Benefit Plans: LuminX processes claims for medical, dental, vision, prescription drugs, flexible spending, short/long term disability benefits and continuation coverage mandated by the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA).
Integration of Systems: The LuminX system integrates claims processing with accounting, group billing and administration, and management reporting. Billing, accounting and management reporting databases are automatically updated from the claims processing system.
Participant Tracking: LuminX tracks historical claim activity for every plan participant including images of all EOBs, correspondence and claims related documents, and a log of all phone calls related to claims activity. This feature allows customer service to instantly respond to telephone inquiries rather than sort through voluminous paper files.
Adaptability: LuminX is a dynamic system, adaptable to new federal and state laws and regulations enacted each year that affect employers and their benefit plans. Acclamation Systems, Inc. is committed to providing the programming necessary to keep LuminX compliant with all federal and state laws and regulations.
Reporting: LuminX provides comprehensive operational and management reports to measure and control the costs of the claims processing operation and of the health care provided. The health care management reports provide measurement tools to assist in the creation and monitoring of cost containment strategies. The system includes a user-oriented report generator that satisfies many ad hoc reporting requirements.
Electronic Data Interface: The LuminX system is designed to accept a variety of EDI formats and automatically import claims information into the LuminX workflow. The system supports the current NSF electronic claims formats for HCFA and UB92 claims submissions from our EDI clearing house Health-e-Web. Major enhancements to make the system fully compliant with the HIPAA mandated EDI standard transaction sets is in the final development stage.
Interactive Voice Response System (IVR): The LuminX IVR System allows providers and participants to access claim status and verification of benefit information by telephone 24 hours a day without customer service personnel intervention.
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