Full-Circle Revenue Cycle Solutions...Revenue Cycle: Pre -Bill & Post -Bill Solutions Robust rules engine improves claim validity and accuracy, delivers positive cash flow, maximizes

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Full-Circle Revenue Cycle Solutions Q1 2021

Confidential and Proprietary Information



Alpha II OverviewSince 1980, Alpha II delivers revenue integrity across the full continuum of care by enabling proactive denial intervention throughout the RCM workflow, eliminating revenue leakage, and maximizing reimbursement.

80k+ ProvidersPhysicians, ASC’s, SNF’s, and

other ancillary providers

Broad Market ReachAmbulatory | Acute | Post-Acute

25+ Milliontransactions processed monthly

97% client retention rate

12 yearsaverage client tenure

30+ Channel PartnersPM, EMR, RCM, Clearinghouse


Revenue Cycle: Pre-Bill & Post-Bill SolutionsRobust rules engine improves claim validity and accuracy, delivers positive cash flow, maximizes reimbursement, and saves valuable staff time through denial prevention.

Adjudication Edits: Accurate and efficient claim adjudication

Pre-BillClinical Coding and Billing Edits:Comprehensive clinical claim and encounter scrubbing solution covering the entire continuum of care

E&M: Accurate, audit-ready coding for evaluation and management services

Advanced Beneficiary Notice of Non-Coverage:If an ABN is required based on medical necessity or frequency limitations, the clinical staff can generate the form on-demand.

Post-Bill

Zero Balance & Underpayment:We identify underpayments, prioritize the high-dollar opportunities and engage your team in meaningful work.

DRG Validation: Advanced rules engine uncovers trends and patterns in incorrect coding

Education: Monthly webinar on denials avoidance/prevention to ensure dollars are maximized early in the revenue cycle.

Denial Avoidance: Root cause analysis to identify and correct issues related to denials and underpayments.

Deep Coding Content Combined with Multiple Edit Severities Enable End-Users to Catch Every Error

Proprietary Content /

Rules Engine


Incorporates a full suite of professional,

institutional, and quality reporting edits based upon extensive

coding and billing requirements

TailoredTimely ContentProactive Updates Results

Health Information ManagementComprehensive clinical claim and encounter scrubbing solution covering the entire continuum of care

Improves claim validity and accuracy, deliver positive cash flow, maximize reimbursement, and save valuable staff time through denial prevention.

Full Suite Workflow

700M+ transactions managed from 2018 –2020 with an average pre-bill denial rate of 11% identified for our

clients

Content Database Updated Daily

-Institutional and

professional edits-

Different specialties

Verifies encounter and claim data from the

payer’s perspective and allows for corrections

prior to filing.

Designed to deploy across multiple

workflows within the revenue cycle.

Customizable & User-friendly interface


Designed by a physician and validated by

healthcare consultants, compliance managers,

and auditors.

Eliminates subjective

component of medical decision

2.8k Healthcare Practices representing 11.8k Providers utilize

E&M Generate integrated in their EHR

applications.

Considers additional factors like review of

prior medical records and consultations

Assigns acuity value to every diagnosis based

on the severity and status of the presenting

problem

Assigns risk values to diagnosis codes,

diagnostic tests, and other management options to ensure precise medical

complexity.

Deep Knowledge

Reduces Audit Risk

Proprietary Method Results

Health Information ManagementAccurate, Audit-Ready Coding for Evaluation and Management Services

Patient history and exam elements, combined with a risk and diagnosis acuity, provide the medical decision component and determine the appropriate E&M level of service.


Medicare patients recognize the Advance Beneficiary Notice of

Noncoverage (ABN) as a necessary step

toward ensuring proper payment for some non-

covered services.

2.9k Healthcare Practices representing 11.9k Providers utilize ABNgen integrated in

their PM/EHR applications.

Tracks services with Medicare policy

frequency limitations

Returns completed ABN and the policy that

triggered the decision of non-coverage

Uses patient’s diagnosis and

procedure to verify medical necessity for

Medicare LCD and NCD policies

Medicare Patients

Simplify Process Deliverable Results

Health Information ManagementSimplified Medical Necessity Verification for ABNs

Per CMS, a knowledgeable practice representative must explain to the patient why the service is non-covered, the options to receive or deny the service, and provide an accurate cost estimate for the service all before asking for a signature.

Using demographic information to complete ABN

Simple interface generates ABN

quickly

Medical Necessity

Medicare Policy


Verifiable pricing calculation to over a dozen Medicare Fee

Schedules

Denial Prevention: Focused proactive

approach

Specifically designed to deploy across various clinical and financial

workflow

Direct platform integration, or a simple

upload/download (working towards API integration in 2021)

Long time support of the VA’s claims

adjudication process and fee schedule development has

brought additional depth to the

Company’s rule engine

Fee Schedules

Large Partner Integration Results

Health Information ManagementAccurate and efficient claim adjudication

Empower and enable “preemptive” Denial Prevention to maximize your earned revenue. Claims adjudication can be a quick process when a clean claim is received.

Currently used by the VA to price all

of their Community Care claims

Rules Engine Workflow


- Line item denials on claims that were paid

- Missing, inaccurate or duplicate claim

information- Medical Necessity- CMS rule changes

- Missing or incorrect modifiers

- Fee schedule updates

Education on denials avoidance/prevention to ensure dollars are

maximized early in the revenue cycle.

Root cause analysis to identify and correct

issues related to denials and underpayments.

Physician practices see between five and ten

percent of claims rejected by commercial and public payers each

year.

We identify underpayments,

prioritize the high-dollar opportunities

and engage your team in meaningful work.

Key Focus

Cash Acceleration

Physician Practices

Denial Prevention

Revenue IntegrityThe Alpha II ZBR team takes it a step further by optimizing your team’s use of our tools to prevent revenue leakage on an ongoing basis.

Industry trends indicate that 90% of denied claims are preventable – the combination of solid scrub rules and continuing training and education that Alpha II’s experts can deliver creates industry best-practice billing to drive that prevention.

Maximize reimbursement –

Alpha II assumes all the risk with

contingency based pricing.

Revenue Intelligence

Root Cause


Thank you for your time. We look forward to working with you.

Anna MonsourSales Solutions [email protected]

Alpha II · 2074 Summit Lake Drive · Tallahassee, FL 32317 · USA800-825-7421 | www.alphaii.com

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Full-Circle Revenue Cycle Solutions...Revenue Cycle: Pre -Bill & Post -Bill Solutions Robust rules engine improves claim validity and accuracy, delivers positive cash flow, maximizes