Insurance and Payment Policy
Insurance coverage is between a member and their insurance company. Insurance policies vary. It is the member’s responsibility to fully understand the details of their insurance policies. Furthermore, patients are responsible for notifying our staff of any changes in their insurance coverage when they check in for their appointment; failure to do so may result in charges that they will be responsible for paying. All payments, co-payments, co-insurances, and deductible amounts (when applicable) are required at the time of check-in.
Prior to your visit, our staff will verify your insurance benefits. We will need your insurance information prior to your visit in order to do this. If we are unable to verify your insurance information, you will be asked to pay in full for your visit or you may choose to reschedule your visit until we can verify the information.
If the insurance company has not processed and paid your insurance claim within 90 days, the payment will become your responsibility. Delinquent accounts will be forwarded to a collection agency. You will also be responsible for all fees including, but not limited to, collection fees.
If AHC does not have a contract with your insurance company, we will file your primary insurance claim for you. In return, we expect payment in full at the time of your visit. We will instruct your insurance company to send any payments directly to you. Please note that the reimbursement from your insurance company will depend upon your terms of your insurance policy.
As a courtesy, AHC has established a discounted fee schedule for self-pay patients that pay in full at the time of their visit. Otherwise, payment arrangements must be arranged with our billing staff before a patient will be seen by one of our AHC providers.
Please refer to our Financial Policy for more detailed information.
If you need to cancel or reschedule an appointment, please contact the appropriate AHC office at least 24 hours in advance. Failure to do so, or failure to show up for your appointment, may result in a $25.00 charge. Reminder calls for office appointments are made as a courtesy only. Failure to receive a reminder call or card will not void our cancellation policy. Payment of the cancellation fee may be required before another appointment will be scheduled.
If you have any questions about health insurance benefits, please contact the customer service department of your insurance company. The contact information for your health insurance company will be listed on your insurance card. Senior citizens that have questions about their Medicare coverage can find out more about their options on the following website: http://www.medicare.org.
Veterans Choice Program
Under the updated criteria, a Veteran is eligible for the Veterans Choice Program if he or she is enrolled in the VA health care system and meets at least one of the following conditions:
Enrolled before August 1, 2014:
- Wait times for VA care exceed 30 days from the desired care date or the date medically determined by your physician
- Non-VA care is prescribed by a VA provider
- Live more than 40 miles from to the nearest VA care site – VAMC, community-based outpatient clinic (CBOC), etc
- Live less than 40 miles from a VA medical facility, but face an unusual or excessive burden in getting there because of geographical challenges or must travel by air, boat, or ferry to reach such a facility
- Live in a state without full-service VA medical facilities that provides hospital care, emergency service and surgical care, and reside more than 20 miles from such facility.
Non-VA care is only covered by VA for medical needs that have been approved by your VA physician. To verify eligibility and coordinate your pre-approved care Veterans are encourage to call 1-866-606-8198.
For additional information on Veterans Choice Program and locating participating providers, visit www.va.gov/opa/choiceact.
Requirements & process for Appointment Scheduling via the Veterans Choice Program:
- Health Net Federal Services will send a fax to Advanced Healthcare Center/Pre Registration Department 912-427-9851: Veterans-Appointment Request, Authorization (indicates eligibility and services approved), and Consult Notes
- Once received an Advanced Healthcare Center Representative will contact the Veteran within 24-48 business hours to schedule an appointment
- Advanced Healthcare Center will notify Health Net Federal Services of scheduled appointment
- Health Net Federal Services will issue a Patient Provider Packet with complete authorization information
- Need to Apply for VA Health Care Benefits? Complete an application online www.va.gov , Go to your local VA health care facility, or call 1-877-222-VETS(8387)