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1. Who is ACS?
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Ancillary Care Services (ACS) is a national ancillary benefits management company based in Dallas, Texas. We focus on reducing our clients’ medical costs through cost containment strategies for ancillary services. ACS has developed the most cost-effective, comprehensive, proprietary ancillary provider network available today. Our customers include: insurance companies, managed care networks, self-insured employers, TPA's, unions and workers' compensation benefit administrators. |
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2. What are ancillary services?
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Ancillary services represent one of the fastest growing components of healthcare costs. The ACS network includes 26 primary specialties with over 30 subspecialties. Primary services include:
- acupuncture
- cardiac monitoring
- chiropractic
- diagnostic imaging
- dialysis
- DME
- genetic testing
- hearing aids
- home health
- hospice
- infusion services
- laboratory services
- lithotripsy
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- long term acute care
- massage therapy
- orthotics & prosthetics
- pain management
- podiatry
- rehabilitation
- Skilled Nursing Facility
- sleep diagnostics
- surgery centers
- transportation
- urgent care centers
- vision
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3. How large is the ACS network?
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ACS's national network has over 24,000 provider sites and the network is growing by 25% per year. |
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4. What's fueling the growth in ancillary services?
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The major drivers for increased use of ancillary services are:
- An aging population
- Rising healthcare costs are forcing Payors to seek alternatives to costly in-patient care
- New technologies which, in some cases, are making ancillary services a viable option to in-patient care
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5. How does ACS bring value?
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ACS specializes in the management of ancillary services. Our network controls ancillary costs and increases the quality of services. By utilizing our network, ACS clients leverage our specialized experience in contracting with and managing ancillary providers.
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6. Can an MCO be just as effective in ancillary benefits management as ACS?
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It's possible; however, because ancillary costs have historically represented a relatively small percentage of total healthcare dollars, most MCO's focus their time on acute care and physician contracting. Comprehensive, ancillary contracting is not a primary focus or part of their core business. Ancillary management also poses special challenges since the providers are numerous and diverse. Ancillary benefits management is ACS's core business. |
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7. If a payor already contracts to use PPO networks, do they need ACS?
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In many cases we find that PPO's cannot dedicate the level of staffing required to contract with the broad spectrum of ancillary providers. Their clients demand that contracting efforts focus on physicians and hospital systems. Consequently, most PPO's lack the business focus necessary to drive costs out of ancillary services. Our ancillary contracting specialists do a more effective job of contracting because it is our contracting focus.
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8. How does the process actually work?
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Claims are sent to ACS via EDI or paper. ACS re-prices the claims, issues a transmittal sheet or outbound EDI transmission to its client or payor which show billed charges, ACS re-pricing and client savings. The payor remits payment to ACS and ACS pays its providers.
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9. Can ACS bring value to an HMO?
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Yes. Our expanded network provides HMO members with more choices, which in turn contributes to member satisfaction. All HMO's incur a percentage of ancillary claims that are generated in geographies that are not within the HMO's service area, and when this happens, HMO's are required to pay expensive billed rates or take valuable time to "negotiate" fees. Through the ACS network, HMO's will expand their ancillary network and reduce ancillary costs.
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10. What is ACS's average savings per claim?
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We generally save our clients 30% to 35% on ancillary services claims. This includes expanding the clients’ in-network claims through the ACS network, and achieving greater discounts through the ACS network for providers previously contracted. The actual savings depend on the clients’ demographics, plan benefits, geography and how aggressively the client has been developing an ancillary network.
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11. Does ACS provide services in rural areas?
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Yes. We have many local and regional providers. Local providers are a real ACS strength.
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12. Are providers "surprised" when new enrollees present their cards or seek service?
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No. We take pride in our history of staying in touch with providers and telling them when new clients join us. This is the key to our success and differentiates ACS from other networks.
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13. What investments are ACS clients required to make and what is the potential ROI?
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ACS clients do not make a financial investment; our clients can leverage the ACS network with “No” out of pocket cost. ACS brings immediate medical cost reduction and savings go to the clients’ bottom line.
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14. How can organizations determine if ACS will produce savings?
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Our clients generate significant savings through the ACS network by leveraging our investment and expertise in ancillary contracting. To quantify these projected savings, ACS will compare the client’s actual claims data to the ACS network and contract rates. The Network Value Analysis (NVA) tool used in this process will provide us with the information we need to project bottom line savings and show total value to the client.
The best business relationships are based on partnering that starts with our understanding the clients’ commitment to reduce medical costs without sacrificing quality and how we can most effectively deliver our solution to this business problem. The success of the NVA is driven by the quantity and quality of information the prospective client makes available to ACS. At minimum this information must include at least six months to a year of actual claims data.
ACS reduces ancillary medical costs on a claim-by-claim basis and our fees are also generated in the same manner. The ACS revenue model provides us with great incentive to expand the network and negotiate aggressive rates for our clients. Therefore, in addition to the immediate saving's projections, as part of the NVA, ACS will forecast the expansion of our network, which will bring additional value to our clients through a further reduction in out-of-network claims.
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15. How does ACS price its services, i.e. PEPM or per claim?
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ACS charges are built into the re-pricing process. We receive a fee as we deliver savings on a claim-by-claim basis. Our pricing strategy drives us to constantly expand our network.
Charges for paper claims data entry are priced separately.
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16. Is there a minimum cost per month? What is the term for an agreement?
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Based on the Network Value Analysis (NVA), a minimum claims volume is agreed to between ACS and the client. The term for ACS service agreements is three years. |
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17. Will ACS commit to adding additional providers in geographies that warrant additional coverage?
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Yes. The Network Value Analysis (NVA) shows where we will bring immediate savings. Additionally, ACS will commit to expanding the network to bring additional savings and value to the client. |
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