Gender

Female

Location

Naperville, IL

Tell us more about who you are, what you do and where you want to be. What are your main business challenges? (Tip: provide your current Job Title, Industry, company or/and paste your Linkedin profile here). Use as many relevant keywords as possible. Tell us what you can offer the community. What sorts of discussions, events, and activities you can participate in.

I am an Account Executive working for Alpha Review Corporation. Our main focus is on providing the greatest savings possible for medical bills related to workers' compensation, auto and liability claims. We work with small - medium sized insurance carriers, large self-insured businesses and TPA firms. First and foremost is our focus on customer service. When you call our offices during normal business hours, your call is answered by one of our Front Office staff – no electronic phone tree to navigate. Our Sigma Solution process enables an electronic workflow from the provider's submission of the bill (ebill) all the way through to an electronic payment to the provider saving our client's up to 20% on their operating costs. Our expert staff includes on-staff nurses and CPC (Certified Professional Coders) to ensure billings are coded correctly, only appropriate services are rendered according to the covered injury and correct coding initiatives are applied. In addition, we can write client-specific rules to address the individual needs pertaining to a certain claim, provider, service, code, etc. allowing greater systemic control and less dependency on human interaction. As we search to assure the greatest savings possible, we access over 20 National and Regional PPO networks, specialty networks focused on physical therapy (PT), diagnostic imaging, durable medical equipment (DME), and pharmacy benefit programs (PBM). Reporting is available based on any information that is captured as part of the bill review process. We have over 40 standard reports and can also produce the Request for Reimbursement Report for the MCCA for Michigan auto claims as well as the NF-10 for New York auto claims. Our system works so that the client can determine which services would be best for their particular situation and allow them to add new services as they deem appropriate. Our online Gemini system allows our clients a direct portal to see the status of a review, view and or print a copy of a bill image, EOR, NF-10 or C-8, and the option of an approve/deny process. Our in-house IT staff will build EDI files to integrate the data directly with the client’s claim system so all systems remain in sync. We can also integrate Utilization Review (UR) treatment parameters into our bill review system so that they are automatically applied as the medical bill is reviewed. I welcome the opportunity to discuss your current bill review process and how Alpha Review may be able to assist in improving the process as well as savings.

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