Billing for a US state health insurance exchange

Keeping up with shifting federal requirements for state governments creates a unique challenge.

With the advent of the Affordable Care Act, a large state insurance exchange needed an efficient way to charge carriers for the opportunity to participate in its marketplace. No current system existed that would allow for dynamic changes as federal and state policies and programs evolved.

The solution had to be cost-effective and flexible without sacrificing robust technical capabilities core to value delivery.

Accenture Billing & Payments Engine provides an automated system for calculating, aggregating and invoicing carrier fees. Carrier payments are easily processed, and receivables tracked to reconcile carrier balances.

All of this requires only a very small team to oversee automated processes and batch streams.

When the carrier fee calculation changed less than a month from the golive date, Accenture was able to flawlessly pivot the system to remain compliant with the new guidelines - and on track to meet the client’s deadline.

Accenture Billing & Payments Engine enables over millions of dollars in monthly invoicing, covering more than a million participants enrolled with individual, family, and group insurance carriers.

• Automation delivers significant efficiencies in invoicing and payments distribution
• Cost structure for the solution provides striking savings over competitive alternatives
• Configurable software and experienced teams accelerated delivery and time-to-value