Product

PRIORITIZE AUTOMATION TO ACHIEVE THE GREATEST REVENUE CYCLE OPERATIONS SAVINGS.

PRIORITIZE AUTOMATION

Prioritize High Volume RCM Activities to Achieve Measurable Impact

Alpha Health’s Unified Automation approach works across the revenue cycle using your existing systems and established processes. The software autonomously observes and documents processes, capturing multi-modal data which provides a 360 degree view of all workflows, not just a fraction of them. Broken or inefficient workflows are corrected and unnecessary work is eliminated. Finally, we combine automation with our team of revenue cycle experts who step in when the system encounters an exception or something new (including changes in business processes and outlier cases). The system learns from the actions these experts take so it can autonomously complete this work going forward, pushing outlier cases further and further to the margins.

Automation across the entire revenue cycle process, from eligibility through payment, can help healthcare organizations save millions of dollars in recovered revenue annually. We have identified the four stages of the RCM process with the highest volume activities that will provide the biggest impact quickly based on real-world experience with our customers. They also happen to bookend the revenue cycle process.

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ELIGIBILITY:

Leverage machine learning to automatically input insurance card scans into registration/EMR system fields and check eligibility on the front and back end of revenue cycle. This will prevent denials and reduce rework out of the business office.

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PRIOR AUTHORIZATION:

Identify authorization requirements, initiate authorization via payer websites, and check authorization status to ensure patients are fully supported by their third-party coverage to receive care with full reimbursement. Authorizations are one of the leading causes of denials, so this will prevent denials and reduce back-end work associated with denials appeals.

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CLAIM STATUS:

Complete follow up to claims with no payer response by checking the claim status on payer websites, pulling back relevant information into EHR/PAS, and prioritizing the need for escalation with the payer. This will drive down A/R and increase your cash flow.

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DENIALS MANAGEMENT — APPEALS, ADJUSTMENTS, AND REBILLS:

Automatically appeal technical or clinical denials by pulling the relevant clinical data from the EHR and applying the most effective appeals templates. Where adjustment is required due to managed care requirements or accounting practices, automatically perform that task and free up your team to tackle more meaningful, revenue-generating activities. This decreases overall write-offs rate and increases collections.

TRUST & SECURITY

We’re Serious About Security

Your trust matters to us and we’ll never risk your confidence. Alpha Health is secure by design. Our technology works within our customers’ existing ecosystems, abiding by their controls and creating audit trails in their systems. In fact, we capture records of every action our technology takes, so we not only ensure we stay compliant, we can enhance your team’s compliance as well.