Accumulators are the method of precisely collecting and calculating total claim dollar values against plan deductibles and benefit limits. Managing claims accumulator data in a timely fashion can be both difficult and costly to a health plan. Accumulators that are shared between core medical and third party benefit partners such as pharmacy, mental health, dental and vision can be especially vulnerable to out-of-sync data.
By connecting Appian, Luxoft offers a secure, reliable, and auditable way for health and pharmacy benefit plan systems to share and update real-time accumulators. With the power of Blockchain, discrepancies and the need for manual intervention is eliminated. The application implements accumulator business rules on blockchain using Hyperledger Fabric. Fabric Channels was used to isolate and secure data across medical and pharmacy benefit partnerships.
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