Checking Claims Status

To assist you in checking initial claims status, The Alliance has created an online Claims Portal. In addition to being able to generate your own customized Claims Processed Report, this interactive website also allows you to search for specific claims that have been submitted under your tax ID number.

• To sign up for The Alliance Claims Portal complete
  and return this form to providerservices@the-alliance.org.

Tips for Speeding Claims Payment
Did you know that in an average year, we receive and reprice more than 700,000 claims? That's more than 2,500 every day. Our average turnaround for electronic and paper claims is about half a day.

Here are a few tips to make sure your claim is handled as quickly as possible:

• It's okay to staple claims. In fact, we'd prefer you did.  If you send us paper claims, with additional documentation, go ahead and staple them together for the quickest and most accurate processing.
• Include provider name and degree in Box 31 of all CMS forms.  The degree or education level of the servicing health care provider is required to reprice most claims.
• If you don't already, learn more about sending and receiving health care claims electronically: It's the most efficient way to ensure you're paid in the timeliest manner.

Sending Claims Electronically Can Speed Claims Payment
Sending and receiving health care claims via Electronic Data Interchange (EDI) is an efficient way to receive more timely payments. With EDI claims we are able to reprice and send the claim on to the TPA in just a few hours.

If you currently don't have EDI connectivity with The Alliance, please contact Dave Sell or at 608.210.6656 to learn more.

Streamline EDI Processes for Timely Reimbursement
Follow these tips to ensure electronic claims are always accepted on the first submission:

1. Confirm Alliance network status at each office visit: Check a patient's health plan identification card at each visit to ensure that there haven’t been any changes in eligibility or employment status.
2. Enter names exactly as they appear on the ID card:  Entering nicknames, such as Shelly when the ID card refers to the person as Michelle, can cause an electronic claim to be rejected. Another common mistake is entering a name without punctuation. For example, “John Smith-Gentry” is not the same as "John Smith Gentry".
3. Enter the exact number on the front of the ID card:  The member number must match exactly as it is listed on the member ID card. If your organization normally adds a two-digit suffix, please remove it before submitting the claim to us electronically.  

Getting Answers is Easy When you know Who to Call.