 |
March 2020
|
|
Operational Updates | Alliance Announcements | Employer Stories
|
|
|
|
Operational Updates
|
Issuing ID Cards for Alliance Members
|
 It is important to copy the patient’s name and number exactly as it appears on the card. If you submit claims via Electronic Data Interchange (EDI), this ensures the claim is always accepted on the first submission. The Alliance works with two clearinghouses for electronic claims submission, Change Healthcare and Relay Health. The Alliance payer identification numbers are as follows: Change Healthcare # 88461; Relay Health 1500 CPID # 2712; Relay Health UB CPID # 1935. Please direct questions about payer identification numbers or EDI connectivity to The Alliance.
The TPA maintains eligibility information, determines if services are covered, processes claims for payment, and handles precertification, if needed. Call the TPA if you have questions about claims status, benefits, eligibility, or pre-authorization.
Please send all medical/surgical, home health, mental health, and chiropractic claims to The Alliance.
|
|
|
|
Credentialing Requests for Medical Providers
|
The Alliance uses services from partner organizations to assist with provider credentialing. WPS Health Insurance, and their CVO, Eddy, provides credentialing services for medical providers contracted by The Alliance. Partnering with these companies allows The Alliance to fulfill its requirement for a credentialed network while reducing the paperwork burden for providers.
As a provider of The Alliance, you may be asked to complete credentialing materials by either of these organizations to maintain your status in The Alliance provider network. It is important to respond promptly to credentialing requests to avoid disruption of your participation status.
The current provider registration and credentialing process includes:
- The Alliance will send your provider registration forms for completion. Once completed, please send them to The Alliance for processing. This allows The Alliance to list your practitioners and facilities in our on-line member directory and process claims appropriately.
- If credentialing is required, then WPS or Eddy will contact you to complete credentialing application(s).
- WPS/Eddy will gather the credentialing information from your practice and make an approval recommendation to The Alliance.
- The Alliance makes the final approval decision and contacts your organization with credentialing approval date information.
Here is a sample of the letter you may receive from WPS/Eddy requesting that you credential your providers.
Please let us know if you have any questions or concerns regarding the credentialing process. You may email us at providerservices@the-alliance.org or call Lori Madigan, provider relations supervisor, 608.210.6631
|
|
|
The Alliance Announcements
|
Please join us in welcoming Xia Xiong to the Provider Relations and Network Development Team!
|
Xia (pronounced “Zee-Uh”) joined us on January 6th in the role of Provider Relations Assistant. He most recently worked for The Alliance in the claims department as a Data Entry Associate.
Interesting facts about Xia: Xia used to be an armored truck guard, but is now a freelance writer on the side.
|
|
|
Membership Numbers
|
The Alliance currently covers more than 105,000 individuals from 275 employers in the Midwest.
|
|
|
Blog Posts
|
|
|
|
|
The traditional health care model can be hard to access, tough to navigate, and unnecessarily expensive. But there’s another way you can approach primary health care that makes your employees healthier and helps with your bottom line — advanced primary care. Read more >>
|
|
|
|
|
|
|
|
The Alliance delivers a high-performing provider network that employers can use as a platform for benefit plan design and innovation. Read more >>
|
|
|
|
|
|
|
|
The Alliance supports a robust platform of health policy priorities, in part because federal and state governments are significant purchasers of health care services and play an essential role in driving value based payment. Some recent findings highlight the degree to which government purchasers have influenced advancing value based payment. Read more >>
|
|
|
|
|
Employer Stories
|
- How Trachte Used Self-Funding to Build a Better Health Plan
Trachte Building System’s total cost for self-funding its employee health benefit plan has decreased every year since 2012. During that same period, its workforce has more than doubled. Read the case study.
- Doing Health Benefits Differently with Self-Funding at Brakebush Brothers
Did you spend less on health care benefits in 2018 than you spent in 2014? Brakebush Brothers did. Self-funding was the first step toward changing the health care cost curve at Brakebush Brothers Inc. in Westfield, Wis. Read the case study.
|
|
|
|
|
|
Let us know how we are doing!
|
|
|
|
|
|
|
To unsubscribe from Alliance emails please click below.
|
_1009850.jpg)
