Enhance Your Claims Management with ALYCE

Built-in repricing engine that automatically reduces medical costs without external services.

• Instantly generate payments to providers
• Support for state surcharges (ex: NY HCRA)
• Adjuster approval workflows
• Create and auto hold payment if insufficient reserves.
• QA workflows for complex bills
• Real-time repricing calculations
• PPO network integration
• Track provider billing practices
• Bill and line charges can be charged back to the claim
• Automated savings reports
• Instant and Bulk EOB Generation
• Show EOB details on check stub

Reduce data entry by importing provider bills, CMS-1500, UB’s, etc., along with their document images, supporting notes and other invoices directly to the claim.

AND

Reduce phone calls from providers by using ALYCE’s automatic interfaces with bill clearing houses, such as Carisk, to publish EOB and payment data back to the clearing houses.

Advanced AI analyzes patterns to predict claim outcomes and recommend optimal actions.

• Claim outcome predictions
• Settlement recommendations
• Cost forecasting
• Risk scoring

AI-driven insights help adjusters make better decisions faster.

• Treatment plan analysis
• Medical necessity reviews
• Settlement timing optimization
• Resource allocation suggestions

Direct connections to major Pharmacy Benefits Managers for prescription management.

• Real-time prescription verification
• Formulary compliance checking
• Prior authorization workflows
• Pharmacy network management

Pre-built interfaces with excess and standard carriers for seamless data exchange.

• Excess carrier reporting
• Automatic claim notifications
• Bordereaux generation
• Settlement coordination

Comprehensive payment management with automation and tracking.

• Automated payment scheduling
• Check and voucher printing
• 1099 generation
• Payment reconciliation

Automatic diary creation and management to ensure nothing falls through the cracks.

• Automatic diary creation based on dates, financials, adjuster actions
• Customizable reminder intervals
• Priority-based queuing
• Team assignment capabilities

Create and store state regulation forms

• Prefill with claim data
• Save and Print as PDF
• Automated export to jurisdiction
• Store on claim

Comprehensive notes for tracking claim history

• Customizable Note Templates based on note subject
• Searchable content
• MS Outlook integration

Complete OSHA segment tracking and reporting for workplace safety compliance.

• Incident classification
• Days away/restricted tracking
• Medical treatment records
• Produce 300, 301, and 300A reports for multiple locations.
• Generate .CSV files for upload to osha.gov

On-demand PDF and Excel reports

• Real-time dashboards
• Custom report builder
• Scheduled report generation with automatic deliveries
• Executive summaries
• Month End static data captures

Automated Medicare reporting compliance with built-in CMS Section 111 interface.

• Direct File Interfaces with CMS
• Query response reports
• Settlement reporting
• Scheduled Reminders

Perfect for TPAs managing multiple clients with separate reporting and billing.

• Client-specific dashboards
• Segregated reporting
• Individual billing
• Custom branding options

Customizable workflows that adapt to your organization’s unique processes.

• Configurable approval chains
• Custom status definitions
• Automated task assignment
• Escalation procedures

Pre-build and customizable form letters for consistent communication.

• Template library
• Custom letterhead

Complete workers’ comp management with all required features and compliance.

• Injury classification
• RTW tracking
• Medical management
• Disability calculations

Comprehensive auto claims handling for both liability and property damage.

• Vehicle damage assessment
• Financial Buckets based on coverage
• Total loss handling
• Track incidents with multiple drivers

Property damage claims with integrated vendor management and estimating.

• Property damage assessment
• Vendor management
• Estimate tracking and savings

Access Alyce from anywhere with our secure, cloud-based platform – no software installation required.

• Cross-platform compatibility
• Mobile-responsive design
• Secure SSL encryption
• Multi-Factor Authentication

Award-winning customer support with fast response times and expert assistance.

• Dedicated support team
• Phone and email support
• Implementation assistance

Scales seamlessly from single-person operations to 150+ user enterprises.

• Flexible user licensing
• Performance optimization
• Load balancing
• Automatic scaling