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Cumberland County CommuniCare Enjoys Real-Time Sync with MCO using AlphaFlex

AlphaFlex’s real-time syncing with the MCO’s system ensures claims are complete before billing.

For nearly 20 years, Cumberland County CommuniCare has been “strengthening families and youth at risk” through a variety of prevention and intervention services. The nonprofit agency has also strengthened its relationships with payers over the past few years by streamlining billing with the real-time syncing capabilities of Mediware Information Systems’ AlphaFlex and AlphaMCS payer software.

“When I researched the EHR programs out there, AlphaFlex was the best by far,” says Sarah Hallock, executive director at Cumberland County CommuniCare, located in Fayetteville, North Carolina. “The greatest benefit for us is that it’s compatible with what our MCO is using, so I don’t have to worry about duplicate forms like I would have to in other systems. Everything matches the expectations of our payer.”

AlphaFlex EHR Software

“When I researched the EHR programs out there, AlphaFlex was the best by far.”

Sarah Hallock,
Executive Director,
Cumberland County CommuniCare Inc.

Since going live with AlphaFlex, the professionals at the agency have been able to:

  • Work more cohesively and efficiently with their managed care organization (MCO), state payers, Medicaid, and private insurance companies
  • Ensure that claims are complete before billing
  • Track denials (along with the causes for denial) and easily rebill electronically

Streamlined billing

Among its many features, AlphaFlex manages providers’ unique billing requirements with ease. This has been an especially helpful attribute for Cumberland County CommuniCare, on which North Carolina’s 12th District court system heavily depends. “We are a very different provider than others because our agency does a lot of billing that deals with grant funding,” Hallock says. “We have a broad mixture of how our billing is processed.” Although this can provide some challenges, communication is always at the forefront because AlphaFlex allows the agency’s staff to view the status of claims to its MCO within 24 hours.

Complete claims

The agency’s ability to share and sync data in real time with its managed care organization has improved the accuracy of client information and billing, according to Hallock. She adds that Mediware’s electronic signature feature also has been helpful. “In all of the other EHR systems I looked at, we would have to do the work and then come back at some other point and enter it in to AlphaMCS’s required paperwork, but this program is already compatible with what we’re doing online,” she says.

Fewer denials

Since the switch to AlphaFlex, Cumberland County CommuniCare has received fewer denials. Hallock explains that it’s because the software helps the agency’s professionals send more complete claims the first time. “It improves the accuracy of client data we share; we talk the same language and know what it takes to bill correctly,” she says. “If we do get a denial, we can see the reason why and rebill quickly.” The team can also correct the errors moving forward. As a result, AlphaFlex has been a valuable asset to Cumberland County CommuniCare and has helped the agency spend less time on business operations and more time caring for clients.

About Cumberland County CommuniCare

Founded in 1998, Cumberland County CommuniCare is a nonprofit organization that specializes in providing parenting/family strengthening classes; juvenile delinquency/early interventions; and mental health, substance abuse, trauma therapy, and case management support services for people of all ages in Cumberland County, North Carolina.

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