Alpha II, PCIS Gold enter integration contract

Mar 28 2011

Alpha II, a leader in healthcare coding, compliance and reimbursement, announced today a new integration contract with PCIS Gold, a provider of single-source medical group practice software. Alpha II's ClaimStaker software will enhance coding reliability, while increasing professional and institutional claim validity for PCIS Gold's customers.

“We're widely recognized for our solutions that help group practices improve workflow while reducing overhead. The addition of ClaimStaker provides our customers with the ability to build in claims efficiencies and increase their revenues.”

While LCD/NCD data provides coverage rules for only a fraction of all CPT codes, ClaimStaker's added proprietary clinical medical necessity database and granular edits allow practice management systems to support virtually all possible ICD-9/CPT code combinations. Using essentially the same technology payers use, the software is designed to increase cash flow and demonstrate clinical defensibility for providers by editing claim files prior to submission. ClaimStaker is used by IT vendors and other developers as embedded software or can be implemented as a stand-alone solution.

"PCIS Gold serves a broad base of large and small customers across dozens of medical specialties, so the flexibility that ClaimStaker brings as a claims scrubbing application was important to us," noted Todd Frischknecht, national sales director of PCIS Gold. "We're widely recognized for our solutions that help group practices improve workflow while reducing overhead. The addition of ClaimStaker provides our customers with the ability to build in claims efficiencies and increase their revenues."

PCIS Gold's practice management software, EMR and ePrescribing applications give physician group practices the ability to access timely, pertinent and comprehensive administrative, financial and clinical information throughout their organizations.

Sterling Rock Falls Clinic (Ill.) is one of PCIS Gold's largest customers, and played a key role in brokering the partnership. Director of IT, Judy Hammett described the reason for the introduction: "When our existing claim-scrubbing software and support was slated to be discontinued by our previous vendor, we used it as an opportunity to upgrade our claims submission efforts and secure timely, more accurate reimbursement. We learned quite a bit about the value that Alpha II's ClaimStaker brings, and knew that the integration with our PCIS Gold solutions would give us the assurance that comes from a clean, efficient claims process."

Alpha II's ClaimStaker augments PCIS Gold's systems through the use of the industry's most comprehensive medical necessity database. "We're pleased to be integrating with PCIS Gold's PMS applications," said Stuart Newsome, vice president of business development at Unicor Medical, one of the software developers behind the Alpha II cobranded solution. "Through this integration, Sterling Rock Falls and other PCIS Gold customers will now be able to verify both professional and institutional claims from the payer's perspective, while using some of the most advanced EMR/PMS offerings on the market."