The Company’s proprietary, next-generation technology platform seamlessly drives all elements of AHCS including physician dispensing and inventory management, automated claims management and customer relationship management. Because of the platform’s unique architecture and centralized data management capabilities, AHCS is able to leverage all of its collective knowledge – complex workers’ compensation protocols, Payor payment rules, physician relationships, claims processing intelligence, supply chain management, company operations – from one single source rather than multiple, interfaced solutions from third-party vendors. This core technology platform enables AHCS to easily scale up its operations, continually and immediately apply new knowledge across its entire business, achieve superior operating efficiency, and avoid challenges associated with maintaining multiple, legacy third-party applications. The AHCS solution integrates into existing physician and administrative staff workflow. Through technology, we have become a value-added partner to physician practices, allowing physicians to enhance patient convenience and compliance while significantly improving outcomes.
The intelligence embedded in the Company’s claims management system is nearly impossible to replicate. Its rules-based claims engine is built on 12 years of workers’ compensation claims data, payment rules for over 70,000 payors, and a complex array of state-specific rules and guidelines. The system immediately identifies errors or omissions in submitted claims and automatically pulls required information from practice management systems or prompts the ordering clinic to appropriately correct the claim form. Once AHCS has pre-adjudicated and purchased a claim or a denied claim has been repaired, the claim form is then processed through the Company’s automated print or electronic fulfillment systems for delivery to the payor for final adjudication and payment. The entire workflow, from patient encounter to delivery of the claim to the payor, is fully automated and driven by AHCS proprietary technology.
The knowledge-based underpinning of the system is continually updated to reflect ever-changing payor protocols and state-specific rules, benefiting the entire network of AHCS users. Importantly, the flexibility and power of the system allows AHCS to adhere to its core philosophy of automating claim repair, submitting documentation as needed, and resubmitting every claim until paid. No other billing technology platform facilitates the prospective repair of pending claims and immediate re-submission of all clean claims in real-time based on payor rule changes or denied claims.