Bolster your revenue cycle management with a system built for managed care
Now you can simplify the complicated task of receiving and processing provider claims. AlphaMCS also includes the ability to generate encounter claims to upstream waiver managers, connecting both sides of the reimbursement process to create one seamless solution that gives you complete visibility and control.
Control your risk with up-to-date tools and processes
AlphaMCS keeps you ahead of the constant changes in payer rules. The web-based system is updated continually, so every time you log in, your billing system is up-to-date. This allows your staff to focus on important responsibilities that impact overall risk management.
- HIPAA Compliant claims submission including Direct Data Entry and 837P/I in the required 5010 format.
- Clearinghouse claims routing
- Void and Replacement Claims Processing
- MUE (Medically Unlikely Edits)
- Medicare Override Processing
- SFTP of Claims related files
- Payback and Recoupment processing
Ensure providers follow claim compliance
AlphaMCS automates the tedious process of enforcing billing rules among your diverse network of providers. Here are just some of the tools that you have at your disposal:
- Service Authorization Request tracking
- Utilization Review Documentation and Audit Record
- Manage Admission and Discharge into Services
- Client Budget Tracking
- Claims Management screens with manual claims controls based on system permissions
- Claims audit random sampling
- Sliding fee scale and client deductible tracking
- Benefit Plan maintenance