ACS puts Alliance in Control

Nine months after it went live in May 2021, the Alliance Claims System (ACS) has allowed Alliance Health to control and customize the claims and authorization process in-house and prepare for a smooth transition to operating a Behavioral Health I/DD Tailored Plan.

ACS is a next-generation managed care system designed specifically to meet the needs of managed care organizations and the providers they support. ACS allows providers to view appointments, submit patient claims and treatment plans, check on authorizations, and more.

A big advantage of ACS is that Alliance Health owns the source code and all development and support is handled in-house, eliminating the need to depend on a third party.

“I think from a high level, it’s good to have our own destiny in our hands instead of having to depend on outside influences, for claims especially,” said Jeff Shelley, Director of Core Systems at Alliance. “When we’re supporting it ourselves it gives anyone at Alliance the ability to communicate easily with the development team, and hopefully we can react more quickly than a third-party vendor would be able to.”

The transition for providers has been relatively uncomplicated, Shelley said, mostly because ACS looks very similar to and has the same functionality as the previous managed care system. “Just like with any system there have been some hiccups that we’ve done our best to work through, but we feel good about where we are and how the system is running now,” he said.

Future plans include development of a unified provider portal that will include some of the internal applications that were created outside of ACS, to give providers one place to go to have access to all of the functionality and applications that they will need. In addition, Shelley’s team is working to expand the types of claims the system can handle in preparation for Tailored Plan management.

“The system is really good at handling behavioral health claims, but what we’re doing now is we’re enhancing the system to be able to include the physical health and medical claims that we will be handling in the future,” Shelley said.