Welcome to Alpha Healthcare Services and Solutions
Alpha Healthcare makes registration simple and improves your service level by centralizing billing and demographics details at the first stage of the patient encounter. Referrals, authorizations and patient history – including billing history.
We have a highly trained staff that performs eligibility verification of benefits in order to avoid delays or errors in insurance coverage. Then the team verifies coverage on any primary or secondary payers by utilizing payer websites, automated voice response systems, or by making phone calls to payers. We also offer real-time pre-authorization services for walk-in patients.
We follow a well-structured charge entry process. The detailed steps followed through the process ensure that relevant checks are made at each processing stage. This enables us to manage a zero-error process and provide our services to you with speed and efficiency. Our Billing Resources team has substantial experience and understanding of the US healthcare industry, and offers expert skills in facilitating investigations and enabling quality decision-making.
After the audit by the quality assurance team, the claims are electronically or paper claims will be submitted to the insurance companies.
We have experienced and well trained billing professionals knowledgeable of different kind of EOB’s (Explanation Of Benefits) across ALL PAYERS posting MANUAL and ELECTRONIC PAYMENTS. Payments received from Patient’s and Insurance Companies are posted to the patient accounts in the client’s medical billing system. The posted payments are balanced against the bank deposit slips to ensure payments received are reconciled on a day to day basis.
The CPC certified coding experts at Alpha we can help with physician education and provide the peace of mind of knowing your ICD-10 coding accurately represents your dictated record. By outsourcing your medical coding services to ALPHA Healthcare you can:
ALPHA Healthcare Solutions’ medical coding services help healthcare providers optimize revenue while minimizing compliance risk. Our deep knowledge of revenue cycle best practices, sharp focus on specialties, and advanced workflow management system deliver expert, predictable results. Our comprehensive coding services are available as part of our full medical billing services offering or as a standalone service for organizations doing their own billing. Our closed-loop process is seamlessly integrated with your billing system to ensure the highest degree of data integrity.
We at Alpha Healthcare understand that a good denial management process is not simply about working denials, it is about systematically gathering the data required to eliminate denials.
Our Denial management Process tracks every claim that has denied and can report this by payer, by CPT, by physician and by diagnosis. This information is presented in a manner that allows fast identification of trends. The data and analysis will allow many opportunities for process improvements and revenue enhancement for the practice.
Our powerful Denial Management Solution can optimize your medical billing and speed up your cash flow. As Denial management is a subsection to Accounts Receivables of any medical facility, we religiously follow the below methodology of managing denials from payers. Our solution is focused around the three key fundamentals to effective denial management.
Prevention focuses on actions that can be taken upstream in the patient encounter to prevent denials from occurring in the first place. Prevention can be introduced anywhere in the patient encounter such as: Pre-admit/Pre-registration, Scheduling, Admit/Registration and Billing. Our denial management experts ensure that we track such trends and keep the Client informed periodically about improvements/process changes that can be made across functions.
The process of analyzing and aggregating similar denials is strategic in denial management. The Denial management team at Alpha Healthcare understands that analysis and segregation is a forerunner to follow-up process and hence for us it is an fundamental step in denial management.
Besides keeping a track of the denial trend from payers our experts also actively monitor the payment patterns from various payers and set-up a mechanism to alert when a deviation from the normal trend is seen. This is important in understanding the causes of claim denials and enhancing long-term efficiency and drastically reducing lost revenue.
Often, hospitals and physician practices get into situation of accumulated, unresolved Accounts Receivable due to lack of staff, ineffective policies, or ineffective process management. Such backlogs amount to millions of dollars and require expert A/R team members to recover the maximum amounts possible.
Alpha Healthcare provides exceptional A/R Management services through diligent follow-up, denials and appeals management, patient-centric account resolution, and A/R analytics. Benefits include:
