ALPS Services, Inc. Customer focused flexibility
1. We will perform in an equitable manner and in accordance with laws, regulations, and individual organization standards.

2. All information, including statistics, and personal ideas are held in strict confidence.

3. We will refrain from behaving in a manner that will adversely affect your oganization or ALPS.

4. We will avoid situations which could be construed as a conflict of interest.

5. We will not accept favorable treatment or other rewards which could affect our ability to be objective.

Medical Cost Control Methods

ALPS Range of Services

ALPS Services, Inc. provides comprehensive medical cost control services including utilization management, cost control, and quality assessment services throughout all health care settings.

We offer a full range of review services, including:
  • Medical Records & Medical Bill Review
    (Review medical records in compliance with HIPAA standards and verify that the patient was charged only for services received)

  • Coding and DRG Validation
    (Each claim is reviewed for possible savings potential)

  • Managed Care Review
    (Ensure that only appropriate and necessary care is delivered in the least restrictive settings by qualified professionals)

  • Pharmaceutical Review
    (Verifies utilization and cost of pharmaceuticals is appropriate, medically necessary, and related)

  • Case Management
    (An integral part of pre-certification, physician peer review and discharge planning. Ensures continuity of care. Contains costs by eliminating or reducing unnecessary utilization of resources. Improves patient satisfaction and quality of care)

  • Physician Case Management
    (Enhanced medical outcome, improved dispute resolution, and facilitate better peer to peer communication)

  • Retrospective Review
    (Post medical treatment analysis to determine whether services and costs were reasonable, usual, and customary)

  • Claims Audit
    (Identifies benefit discrepancies and erroneous claim payments)

  • Claims Processing
    (Accelerates the medical claim process)

  • Quality Review/Quality Assurance Assessment
    (Monitoring, evaluating, and/or improving the quality of health care delivered by a health care provider)

  • Medical Record Abstraction
    (Ensuring quality assurance methods to enhance reliability and validity of data obtained from medical records)

  • Surveys and Data Collection
    (Verification of medical data and delivery of medical services)

  • Subrogation (Third Party Liability)
    (Investigate, evaluate and recovery services on a contingency fee basis)

  • Fraud and Abuse Review

  • Provider Credentialing

Customer-Focused Flexibility

This full range of services is offered to all clients as a comprehensive package. However, any one, or any number of these services, can be unbundled to meet your needs. This customer-focused flexibility is one of the key benefits of our service, and our key competitive advantage.

Council on Aging
ALPS is a partner with the Council on Aging of Southwestern Ohio to provide services to the Ohio Home Care Waiver Program. For more information, visit www.help4seniors.org and search Programs and Services.
CMS
GSA
SDVOSB Better Business Bureau Accredited