that you can trustAllianceMed partners with industry professionals to develop services you can trust.Learn More
Leading the way
in research and developmentWe are constantly improving our methods through education, research, and development.Learn More
A friendly staff
for a comfortable experienceWe offer customer service that exceeds our competitors in all areas of our expertise. Learn More
Patient Protection Affordable Care Act and Employee Retirement Income Security Act Specialists. We are Out-of-Network billing experts. Our team of consultants handle all aspects of the billing claim process.
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We make it a priority to cater to each individual practice, physician, ASC, etc. Our Business Development Team is here to integrate our process with your business for a more seamless operation.
AllianceMed uses several methods to overcome low ASC utilization and block times, as well as educate healthcare providers on underutilized components of their business.
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Did you know? Reimbursement for Professional Fees has been on the decline.
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Education is the key to success. Below is our latest educational link.
Key Healthcare Billing Descriptions
Health insurance can be confusing – here are some common descriptions to help you understand.
AllianceMed asks and receives the “contract” each employee has with the insurance company (S.P.D. Summary Plan Description). Each plan may have some degree of limitations on their out of network benefits. We know that those policies can be overcome.
Balance billing is a type of healthcare billing that occurs when an out-of-network provider bills a plan member for the difference between the out-of-network provider's charge and the amount paid by a member's benefit plan for the out-of-network service, and this difference exceeds the member’s defined liability from the Plan. This means that if the defined out-of-pocket for the member was 20% of the provider’s charge and the member pays more than 20% - not due to a deductible application – this is a balance bill. This situation happens when a provider does not participate in a member's provider network. AllianceMed has a legal process of collecting the patients responsibility for out of network services. Our Patient Choice Team speaks with all surgical candidates and informs them of their individual insurance policy.
Several plans pay a percentage of Medicare rates. These restrictions are normally not disclosed in the S.P.D. (Summary Plan Document) as a proper methodology to price a claim. AllianceMed fights these fictitious stipulations.
The Dr. and Healthcare provider should make all clinical decisions. By paying for premium benefits the insurance company has no right to dictate protocols. We hold insurance companies accountable to pay reasonable and customary. If they feel they have paid too much, AllianceMed will handle the situation.
Latest News from Health and Medical
“AllianceMed takes on Blue Cross Blue Shield of Georgia”
AllianceMed is a revenue generating service company that uses state of the art billing process rather than the medical provider. Using the Patient Protection Act we ensure that Insurance Companies are covering all benefits the patient elects to use, including their Out-of-Network benefits.
AllianceMed has an experienced team to handle all aspects of billing including claims, negotiations, and in-house legal counsel for more complex issues. Our teams are up to date on the Patient Protection Affordable Care Act (PPACA) regulations, laws and techniques to be constant innovators in our industry.