eCAMS® HCE
Engineered for Federal Precision.
Acentra Health’s eCAMS® Health Care Engine (HCE) is a federal‑ready, rules‑driven claims adjudication platform designed to deliver fast, accurate, and compliant processing for medical, dental, and pharmacy claims. With proven performance across major federal programs, eCAMS supports 20,000 claims per hour and more than 125,000 daily, while maintaining full compliance with HIPAA EDI, CMS payment guidelines, and ACA prompt‑payment requirements.
eCAMS is backed by an established Authority to Operate (ATO) in secure federal data centers and supports deployment in FedRAMP‑authorized environments, including AWS GovCloud. Its advanced analytics and AI‑driven tools detect fraud, waste, and abuse in real time, while the configurable RuleIT™ engine drives near‑100% auto‑adjudication with high accuracy.
With an intuitive provider portal, integrated enrollment and credentialing workflows, and robust interoperability (HL7, FHIR, X12, NCPDP), eCAMS gives federal agencies a low‑risk, high‑performance platform built for transparency, accountability, and mission success.
A Future-Ready Platform for Fast, Accurate, and Compliant Claims Processing
Clean Claims Right From the Start
eCAMS streamlines claims submission through paper, electronic, batch, and DDE channels. Each claim is validated against HIPAA and SNIP standards, flagging errors instantly so providers can correct issues before adjudication. This dramatically reduces suspensions and keeps clean claims moving.
Adjudication Excellence
At the core of eCAMS is the configurable RuleIT™ engine, which applies comprehensive edit and audit rules—including duplicate detection and program‑specific policies—to ensure accurate, policy‑aligned adjudication every time.
The result? Higher auto-adjudication rates and fewer manual reviews in even the most complex, high‑volume environments with minimal intervention.
Responsive and Scalable
Engineered for throughput, eCAMS processes 20,000 claims per hour, scaling beyond 125,000 claims daily, with single-claim response times of just 2–3 seconds in federal operations.
This performance is powered by concurrent worker threads and has been proven across major federal and state programs.
Built for Compliance & Federal Security
eCAMS fully aligns with HIPAA EDI standards, CMS Medicare payment guidelines, ACA prompt‑payment requirements, and operates with an established Authority to Operate (ATO) in secure federal data centers.
Manual Reviews Only When Needed
While engineered for near‑100% automation, eCAMS applies manual review only to predefined exceptions—such as validation failures, potential duplicates, or unusual billing patterns—ensuring precision without unnecessary delays.
Flexible Fee Methodologies
eCAMS calculates payment at the service-line level, applying Medicare-based, Usual & Customary, or custom fee methodologies. Integrated financial modules generate accurate provider disbursements and maintain full audit trails for payment integrity.
Built for Engagement
A guided, self-service portal streamlines provider enrollment, credentialing, and maintenance. Dynamic workflows ensure complete, compliant applications, while automated notifications keep providers informed at every step.
Compliance You Can Trust
Federal leaders face strict oversight and accountability expectations. eCAMS supports:
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Full HIPAA EDI compliance, including all major X12 transaction sets.
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CMS Medicare payment guidelines and Affordable Care Act (ACA) prompt payment requirements.
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Deployment in FedRAMP authorized environments, including AWS GovCloud.