AdministrativeCommercialJuly 31, 2018

BCBSGa engages with Alliant Health Solutions

As was previously communicated in the December 2017 provider newsletter, BCBSGa has established a contractual relationship with Alliant Health Solutions to assist the organization in validating provider compliance with applicable reimbursement policies and identify instances of incorrect billing for behavioral health services.  Alliant has initiated the work and your compliance is required should you receive a request for information.  Alliant, is a behavioral health audit and review company, and will examine BCBSGa outpatient behavioral health claims data.  Utilizing systematic sampling methodology and a broad range of algorithms, the audits and findings will be customized to support BCBSGa’s expectations as outlined in the BCBSGa Provider Manuals and related policies and procedures.  Alliant findings may result in provider audits and record reviews, education and other direct outreach.