S.C. health care claims work gets assist from ACS

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The South Carolina Health and Human Services Department will get third-party liability and associated services from Affiliated Computer Services through a $19.9 million contract.

The South Carolina Health and Human Services Department will get third-party liability and associated services from Affiliated Computer Services through a $19.9 million contract. The two-year contract has three one-year options.

Under the contract, ACS of Dallas will deliver third-party liability insurance verification, benefit recovery and health insurance program administration services. In the process, the company will develop a new electronic imaging, workflow and data entry system.

ACS also will help detect provider billing errors and possible fraud to achieve the state's third-party liability objectives.

Third-party liability is a category under which insurance providers are billed for medical expenses incurred by recipients of public assistance who have medical insurance coverage in addition to the coverage they receive through public assistance. In these cases, the state pays the difference between the amount of the medical bill and the amount the insurance company has paid.

The company supports more than 20 million program recipients and processes nearly 475 million Medicaid health care claims annually, which represents more than $47 billion in provider payments.

William Welsh is the deputy editor of Government Computer News' sister publication, Washington Technology.

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