What does AHC do for its member providers?

AHC is working very hard for its member providers. We do this as a group and on an individual basis. Our primary focus is to secure managed care contracts to ensure that patients are directed or steered to our member chiropractors. This is done by offering our chiropractic network to other comprehensive networks, i.e. MultiPlan, PHCS, First Health, and Coventry. We refer to these networks as our Network Affiliates. AHC works to obtain favorable fee schedules and contract terms. AHC is currently marketing to networks throughout the Southeast.

Am I required to submit a renewed license or insurance information between the Credentialing cycles?

ActivHealthCare will Primary Source your license, so there is no need to send a copy in annually.

AHC must have verification insurance is current. The simplest way to do this is as follows:

    Insurance – Add AHC as a certificate holder to your malpractice and liability insurance policies. The carrier will then automatically update AHC when your coverage changes or renews.

How long does the Credentialing/Re-Credentialing process take?

The Credentialing Board meets monthly. We request that all paperwork be to AHC by the 1st of the anniversary month. Once the completed paper work has been received by AHC, it takes 30 days to be credentialed and approved by the Credentialing Committee. Once approved, AHC will send you an acceptance letter and forward pertinent information to our network affiliates. It takes up to 90 days for the network affiliates to add you to the participation provider rosters of their contracted claims payors.

What are fee schedules?

A fee schedule is one of the primary points of a contract with a PPO network. The network will establish a fee schedule. It may be a fixed amount, i.e. $32 for a code 98940, or it may be based upon another schedule, i.e. a percentage of Medicare fee schedule. Each contract is different and there is a wide range of fee schedules.

How and where should claims be filed?

In most cases, claims should be sent directly to AHC. In a few cases, the claims would be sent to the address on the insurance card. This is determined during the contracting process and specified on the term summary sheets. AHC distributes a list of network affiliates with claims filing instructions several times a year. If you need an updated list or term summary sheets, please contact our office or visit our website at ActivHealthCare.com.

What formats does Office Ally accept?

Office Ally does accept the HIPAA compliant ANSI 837 format. However, if your software does not produce this format, text files, print-image files and NSF format files are also accepted.

CA Luncheon Reservation

Please complete the information below to make your reservation for the GCA Fall Conference Luncheon on Saturday, October 24, 2015, 1:00 p.m. There is no cost to attend. Please call 770-455-0040, if you have any questions.

Westin Atlanta Perimeter North
7 Concourse Parkway NE
Atlanta, Georgia 30328

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