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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:

Our Specialized Services

Insurance Credentialing & Provider Enrollment

We handle the entire process of getting you in-network with insurance companies, including:

Compliance Assistance

Stay compliant with insurance requirements through our expert guidance:

Comprehensive Insurance Network Development

We help you build a robust insurance network by:

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:

Efficient Processing

Our streamlined approach to credentialing helps:

Ongoing Support

We provide continuous assistance with:

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.

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.

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.

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.

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.

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.

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.

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.

We are dedicated to helping healthcare organizations optimize their operations, ensure compliance, and enhance financial performance.
Partner with us to experience a more efficient way to manage your healthcare organization.

Contact Us

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