About Us
At Alpha Core Healthcare, we are committed to driving excellence in healthcare management and revenue cycle solutions. Our mission is to optimize financial performance and operational efficiency across the healthcare sector. With a deep-rooted understanding of the complexities of healthcare billing and revenue cycle management, we empower healthcare organizations to streamline processes, enhance cash flow, and improve patient outcomes.
We collaborate with hospitals, physician practices, clinical laboratories, nursing facilities, and other healthcare providers, offering tailored solutions that ensure compliance, reduce administrative burdens, and maximize reimbursements. Our approach combines expertise, innovation, and a results-driven mindset to deliver seamless, cost-effective, and scalable solutions.
Alpha Core Healthcare: Your Partner in Insurance Credentialing & Provider Enrollment
Our Vision
At Alpha Core Health Care, we empower healthcare providers to maximize their practice potential through expert insurance credentialing and provider enrollment services. We streamline the complex process of getting in-network with insurance companies, allowing you to focus on what matters most – providing exceptional patient care.
Why Insurance Credentialing Matters
In today’s healthcare landscape, being in-network with major insurance companies is crucial for practice growth and sustainability.
Provider credentialing and enrollment:
- Expands your patient base by making your services accessible to more insured patients
- Ensures steady revenue through established insurance partnerships
- Increases practice visibility within insurance networks
- Streamlines the billing and reimbursement process
- Enhances practice credibility in your local healthcare market
Our Specialized Services
Insurance Credentialing & Provider Enrollment
We handle the entire process of getting you in-network with insurance companies, including:
- Initial insurance credentialing applications
- CAQH profile creation and maintenance
- Medicare and Medicaid enrollment
- Commercial insurance enrollment
- Provider enrollment status tracking
- Revalidation and re-enrollment management
Compliance Assistance
Stay compliant with insurance requirements through our expert guidance:
- Regular monitoring of credentialing expiration dates
- Timely renewal notifications
- Updates on insurance-specific requirements
- Documentation maintenance and updates
Comprehensive Insurance Network Development
We help you build a robust insurance network by:
- Identifying optimal insurance partners for your practice
- Managing applications across multiple insurance companies
- Monitoring application status and following up
- Resolving credentialing issues and challenges
- Maintaining relationships with insurance providers
The Alpha Core Advantage
Industry Expertise
Our specialists understand the intricacies of insurance credentialing and provider enrollment. We navigate the complex requirements of different insurance companies to ensure successful enrollment.
Personalized Strategy
We develop customized credentialing plans based on:
- Your practice specialty
- Geographic location
- Target patient demographics
- Growth objectives
- Revenue goals
Efficient Processing
Our streamlined approach to credentialing helps:
- Reduce enrollment timeframes
- Minimize application errors
- Expedite the review process
- Ensure consistent follow-up
- Maintain accurate documentation
Ongoing Support
We provide continuous assistance with:
- Tracking application status
- Managing renewal deadlines
- Updating provider information
- Resolving enrollment issues
- Expanding insurance networks
Our Promise
Alpha Core Health Care is committed to expanding your practice’s insurance network and increasing your revenue potential.
We handle the complexity of insurance credentialing so you can concentrate on growing your practice and serving your patients.
Take the Next Step
Ready to eliminate your Enrollment issues, expand your insurance network and grow your practice? Contact Alpha Core Health Care today to learn how our insurance credentialing and provider enrollment services can help you achieve your practice goals. Let us handle your credentialing needs while you focus on delivering exceptional patient care.
Our Services
At Alpha Core Healthcare, we offer comprehensive healthcare management solutions including revenue cycle management,
credentialing, and specialized services tailored to meet the unique needs of various healthcare organizations.
Credentialing & Provider Enrollment
Comprehensive provider credentialing and enrollment services to streamline participation in healthcare networks and insurance panels.
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Provider Credentialing
End-to-end credentialing services including primary source verification, license monitoring, and ongoing maintenance of provider credentials. Management of CAQH profiles and other credentialing databases.
Payer Enrollment
Complete Medicare, Medicaid, and commercial payer enrollment services. Handling of PECOS enrollment, revalidations, and updates. Monitoring of enrollment status and expiration dates.
Facility Privileging
Support for hospital privileging applications and maintenance. Coordination with facility medical staff offices and tracking of privilege renewal deadlines.
Medical Coding & Auditing
Expert medical coding services and comprehensive auditing to ensure accuracy and compliance.
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Coding Services
Certified coding specialists handling ICD-10, CPT, and HCPCS coding. Specialty-specific coding expertise including surgical, E/M, radiology, and ancillary services.
Audit Programs
Regular coding audits, documentation review, and feedback for providers. Identification of coding patterns and opportunities for improvement.
Education & Training
Ongoing education on coding updates, documentation requirements, and compliance guidelines. Custom training programs for providers and staff.
Hospital Billing Services
Comprehensive revenue cycle management for hospitals to optimize reimbursement and reduce denials.
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Complete RCM Solutions
End-to-end billing services including charge capture, claim submission, payment posting, and denial management. Specialized handling of both inpatient and outpatient claims.
Denial Prevention
Proactive claim scrubbing, eligibility verification, and pre-authorization management. Analysis of denial patterns and implementation of preventive measures.
Financial Performance
Regular reporting on key metrics including clean claim rates, A/R days, and collection ratios. Customized dashboards and analytics for informed decision-making.
Physician Practice Solutions
Comprehensive practice management and billing solutions for independent physicians and group practices.
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Practice Management
Full-service RCM including charge entry, claim submission, payment posting, and A/R follow-up. Integration with major EHR systems and practice management software.
Specialty Billing
Expertise in specialty-specific billing requirements and regulations. Understanding of unique coding and documentation needs for different specialties.
Revenue Optimization
Fee schedule analysis, contract negotiation support, and revenue enhancement strategies. Benchmarking against specialty-specific metrics.
Clinical Laboratory Services
Specialized billing and revenue management solutions for clinical laboratories and pathology groups.
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Lab Billing Expertise
Handling of complex laboratory billing including molecular diagnostics, genetic testing, and routine lab tests. Understanding of LCD policies and medical necessity requirements.
Compliance Management
Ensuring adherence to CLIA regulations and documentation requirements. Regular updates on changing laboratory billing guidelines and regulations.
Revenue Optimization
Automated charge capture, claim scrubbing, and denial management specific to laboratory services. Integration with laboratory information systems.
Telemedicine & Digital Health
Comprehensive billing and compliance solutions for telehealth and digital healthcare services.
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Telehealth Billing
Expert handling of telehealth-specific billing requirements including appropriate modifiers and place of service codes. Management of cross-state billing requirements.
Digital Health Solutions
Support for remote patient monitoring, virtual check-ins, and other digital health services. Integration with telehealth platforms and practice management systems.
Compliance Support
Ensuring adherence to state-specific telehealth regulations and documentation requirements. Regular updates on changing telehealth billing guidelines.
Healthcare Analytics & Reporting
Advanced analytics and custom reporting solutions for healthcare organizations.
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Performance Analytics
Custom dashboards and reports tracking key financial and operational metrics. Trend analysis and benchmarking against industry standards.
Revenue Intelligence
Advanced analytics for revenue cycle optimization, including predictive analytics for denials and cash flow forecasting.
Compliance Monitoring
Regular audit reports, compliance scorecards, and risk assessments. Monitoring of regulatory requirements and quality metrics.
Partner with us to experience a more efficient way to manage your healthcare organization.
Services
Contact Us
- hello@alphacorehealthcare.com
- (302) 304-8686
- 3524 Silverside Rd, Wilmington, DE 19810, United States
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