Providers - General

Should I join other networks that compete with AHC?

AHC does not restrict providers from joining other networks. But there several points to consider. The large number of competitive networks is a driving force in lowering fee schedule. By supporting other networks, you are limiting AHC's ability to obtain fee schedules on your behalf. A network only exists because you join it. If AHC was the exclusive network for chiropractic, our ability to secure contracts on your behalf would greatly increase and many more carriers and clients would turn to us for access to you.

What are term summary sheets?

A term summary sheet is the summarization of the key points to a contract between AHC and its network affiliates. The term summary sheets are actually a part of your Provider Agreement. As new contracts are acquired, a new term summary sheet is sent to you.

The main components of the term summary sheet include:

Can providers opt out of networks?

Yes, a provider can refuse to accept a network affiliate. Notification must be received within 30 days of the date the term summary sheet is presented to the provider. If there is a change in the way one of our network affiliates does business or if there is an addendum to a contract, we will also allow for a provider to opt out of that network at that time.

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.

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 do I submit a change of address or location change?

To change your address, it is necessary to complete all three of the following forms. You can find these forms on our Forms page under Address Change Forms.

  • Provider Information Form
  • Location Information Form
  • W-9 form.

You may fax the completed forms to 678-990-1124 or mail to:

Credentialing Department
ActivHealthCare, Inc.
1926 Northlake Parkway, Suite 100
Tucker, GA 30084

How do I change or add my tax ID number?

To change your tax ID, it is necessary to complete a W-9 form.

You may fax the completed form to (678) 990-1124 or mail to:

Credentialing Department
ActivHealthCare, Inc.
1926 Northlake Parkway, Suite 100
Tucker, GA 30084

What is the benefit of submitting claims through AHC?

By submitting claims through AHC you will receive in-network benefits. In most cases, this means lower deductibles and higher claims reimbursements. AHC is not a billing service, but we provide a centralized billing service for your paper claims. You can contact us for claims status on numerous patients at one time as opposed to making several phone calls to multiple companies. We will communicate to you the information we receive from the carriers. We will provide a single, easy to read bulk pay remittance that summarizes the information on the various explanations of benefits we receive.

Is there a cost for using AHC for claims billing?

Yes, there is a small administrative or access fee. We are offering you access to network plan participants through your affiliation with us. These fees are usually offset by higher claims reimbursements because of the increased in-network benefits.

What is the benefit of joining AHC?

There are many advantages to being an AHC or I-AHC member. Some of these include: