Publications

You can access our most commonly requested publications below, including the Provider Operations Manual, using the link below each preview.

Finance and claim resources, as well as other useful forms and documents, are available for download further down the page.

Use the convenient table of contents to the right to navigate to your destination.

Alliance Provider Operations Manual

Billing & Enrollment Manual

AlphaMCS Provider Portal Handbook

Network Adequacy and Accessibility Analysis

Cultural Competency Plan

Core Provider Publications

ImageTitleAttachment CategoryTypetopic_hfilterresource_type_hfilter
Alliance Billing Enrollment Manual FY20-21publicationshandbook
Alpha Provider Portal Handbookpublicationshandbook
Cultural Competency Planpublications
Improving Care for Youth with Complex Needs, allliance-health publications new-taxonomy
Provider Operations Manualpublications

Alliance Rate Sheets

ImageTitleAttachment CategoryTypetopic_hfilterresource_type_hfilter
ABA Fee Schedule as of July 1 2019 Revisedrate-sheets providers-new-taxonomy new-taxonomycodes-lists-and-rates
Medicaid Rates FY21rate-sheets providers-new-taxonomy new-taxonomycodes-lists-and-rates
Non-Medicaid Rates FY20-Novrate-sheets providers-new-taxonomy new-taxonomycodes-lists-and-rates
TBI Fee Schedule – update February 2020, rate-sheets providers-new-taxonomy new-taxonomycodes-lists-and-rates fee-checkwrite-schedules

Finance and Claims Forms for Providers

These finance and claim resources give providers access to the most commonly used authorization forms, claim forms, request forms and many more.

ImageTitleAttachment CategoryTypetopic_hfilterresource_type_hfilter
IPRS Diagnosis/Target Population Crosswalkclaims-forms finance-and-claims providers-new-taxonomy new-taxonomy
Place of Service Codesclaims-forms finance-and-claims providers-new-taxonomy new-taxonomy
Place of Service Mappingclaims-forms finance-and-claims providers-new-taxonomy new-taxonomy
ED Reimbursement Request Formclaims-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Paper Claim Submission Requestclaims-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Alpha Claim Adjudication Codesclaims-forms finance-and-claims providers-new-taxonomy new-taxonomyinformational
MCO Accepted Taxonomiesclaims-forms finance-and-claims providers-new-taxonomy new-taxonomyinformational
837 Institutional Companion Guideclaims-forms finance-and-claims providers-new-taxonomy new-taxonomyguidelines
837 Professional Companion Guideclaims-forms finance-and-claims providers-new-taxonomy new-taxonomyguidelines
Invoice and Travel Reimbursement Requirementsbudget-and-invoice-processing-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Invoice Template for Non-UCR Contractsbudget-and-invoice-processing-forms finance-and-claims providers-new-taxonomy new-taxonomy
Trading Partner Agreementclaims-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Budget Formbudget-and-invoice-processing-forms finance-and-claims providers-new-taxonomy new-taxonomy
Provider Payment Election Formprovider-paybacks-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Alliance Vendor Set up Forms – All (Admin, Providers, TBI, and Innovations)vendor-set-up-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Alliance Vendor Set up Forms – Housingvendor-set-up-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Alliance Vendor Set up Forms – Reimbursementvendor-set-up-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Alliance Vendor Set up Forms – TCLIvendor-set-up-forms finance-and-claims providers-new-taxonomy new-taxonomyform
EFT Authorization Agreementvendor-set-up-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Checkwrite Schedule 2021provider-check-write-schedule finance-and-claims providers-new-taxonomy new-taxonomyfee-checkwrite-schedules
Electronic Connectivity Requestclaims-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Federal Poverty Levelclaims-forms finance-and-claims providers-new-taxonomy new-taxonomyform
Electronic Connectivity Requestclaims-forms finance-and-claims providers-new-taxonomy new-taxonomyform

Other Forms and Documents for Providers

Members of the Alliance Provider Network can find other necessary forms, documents and other resources below.

ImageTitleAttachment CategoryTypetopic_hfilterresource_type_hfilter
B3 IPRS DD Support Planothers providers-new-taxonomy new-taxonomy
Certification of Need Medicaid Inpatient Psychiatric Service Under Age 21others providers-new-taxonomy new-taxonomy
Credentialing Staff Assignmentsothers providers-new-taxonomy new-taxonomy
Emergency Relocation Formothers providers-new-taxonomy new-taxonomyform
Guidelines for Implementing Core Rulesothers providers-new-taxonomy new-taxonomy
Innovations Incident Reporting for Failure to Provide Back-Up Staffingothers providers-new-taxonomy new-taxonomy
IVC Designated Facilitiesothers providers-new-taxonomy new-taxonomy
Level of Care Eligibility Determination Toolothers providers-new-taxonomy new-taxonomy
LME Consumer Admission and Discharge Formothers providers-new-taxonomy new-taxonomyform
Member Transfer Tracking Formothers providers-new-taxonomy new-taxonomy
Notice of Change Formothers providers-new-taxonomy new-taxonomyform
Out of State Travel Notification Form 2020others providers-new-taxonomy new-taxonomyform
Practitioner Search Tool Review Formothers providers-new-taxonomy new-taxonomyform
Provider Application Requestothers providers-new-taxonomy new-taxonomy
Provider Network Development Provider Assignmentsothers providers-new-taxonomy new-taxonomy
Provider Portal Access Requestothers providers-new-taxonomy new-taxonomy
Provider Request for Reconsideration of an Action Formcompliance others providers-new-taxonomy new-taxonomyform
Provider Self Audit Submission Instructionscompliance others providers-new-taxonomy new-taxonomy
Provider Self-Audit Templatescompliance others providers-new-taxonomy new-taxonomy
Reconsideration – Consent to Release Informationothers providers-new-taxonomy new-taxonomyform
Record Destruction Logothers providers-new-taxonomy new-taxonomyform
Record Storage Log (Medicaid)compliance others providers-new-taxonomy new-taxonomyform
Record Storage Log (State)compliance others providers-new-taxonomy new-taxonomyform
Relative as Provider Applicationothers providers-new-taxonomy new-taxonomy
Request to Add Clinicianothers providers-new-taxonomy new-taxonomy
Residency Verification Attestation Formothers providers-new-taxonomy new-taxonomyform
Wage Complaintothers providers-new-taxonomy new-taxonomy