Van Duyn Associates has been implementing a series of controls that track Claims as they move through the Blue Cross System. From every data origination point to every data reporting point, claims and their amounts are accounted for in an automated fashion. We utilize the Unitech tool ACR/Detail to track Claim Counts and Amounts through every system at Blue Cross. Any missing claims are listed at their finest level of detail. Additional controls have been developed that automate manual reconciliations.

We have also developed conditional reconciliations when processing large amounts of data. In certain circumstances it is necessary to reduce the processing time when validating data, in order to comply with the Service Level Agreement. In these cases we have implemented a high level reconciliation using controls files, or summary files. These high level reconciliations also use the ACR/Detail reconciliation tool. Only when the high level reconciliation is out of balance does an additional step get run that reads all of the data to provide a record specific identification of the problem records. This improves the efficiency of the daily processing run.