Benefits to Providers
For services eligible under the patients’ primary health insurance, Alliance Secondary plan pays the patients’ out-of-pocket expenses such as deductibles and coinsurance. Claims are paid directly to the healthcare provider via our third party administrator MWG Administators. Alliance Secondary plan provides many benefits to healthcare providers such as, but not limited to:
- ETimely direct deposit payments
- EReduction in Accounts Receivable
- EReduction in the volume patient services that are delayed or avoided
- EReduction in bad debt
- EIncrease in patient utilization
- EImprovement in patient’s physical and financial wellbeing
Claims Process
One of the unique advantages of Alliance ACA Health Supplement is that healthcare providers are able to file all of the claims for patients via an electronic payer code that is clearly labeled on the member’s secondary insurance card (note providers can also file US mail). Here is how the claims process works:
1
Member Shows
Both Cards
Provide both primary & secondary cards at visit.
2
Provider
Verification
Provider verifies coverage with both primary and secondary insurance. Verification Information shown on the back of member ID Card.
3
Provider Files
the Claim
Once the primary insurance has processed the claim, the provider will submit the claim to the secondary insurance by filing electronically or by mail.
4
Alliance Pays
Provider
Secondary insurance processes the claim. The claim will be sent to the provider and the member.
Standard Covered Services
Inpatient - Physicians & Facilities
Maternity Services
Emergency Room Services
Outpatient - Physicians & Facilities
Outpatient Surgeries
Home Healthcare
Mental & Behavioral Health Services
Substance Abuse Treatment
Dependent Pregnancy
HSA Compatibility
Labs, X-rays, Testing, Pathology
Major Diagnostic & Imaging
Physical Therapy
Chiropractic Services
Ambulance Services
Durable Medical Equipment
IV Therapies & Infusions
Chemo & Radiation Therapy
In-Office Physician Procedures
No Exclusion for Pre-Existing Conditions
Non-Covered Services
Office Copays/Physician Consult Fees
Rx Copays: Tier 1, 2, 3 & 4
Services Excluded from Major Medical
Preventative Wellness Services (Covered by Major Medical)
Provider Portal
Click the button below to verify coverage or register to the provider portal:
Claim Filing
Provider filing claim must include 1) itemized bill or HCFA form and 2) copy of the Primary carrier EOB. Hover or choose one below to view payer and contact information:
AmFirst
Verify Coverage
MWG Administrators: (877) 977-9412
Submit Electronic Claims
Change Healthcare: Payer ID: 64090
SoftCare: Payer ID: 01757
Submit US Mail Claims
AmFirst Insurance Company
P.O. Box 211747 | Eagan, MN 55121
Zurich
Verify Coverage
MWG Administrators: (888) 518-6500
Submit Electronic Claims
Change Healthcare: Payer ID: 36423
Submit US Mail Claims
Zurich American Insurance Company
P.O. Box 21203 | Eagan, MN 55121
Transamerica
Verify Coverage
MWG Administrators: (888) 888-2519
Submit Electronic Claims
Change Healthcare: Payer ID: coming
Submit US Mail Claims
Transamerica Insurance Company
coming
Frequently Asked Questions
How do I file a claim?
First, a claim for services performed must be filed with patient’s primary insurance provider. Once the healthcare provider receives the Primary Carrier EOB, they may then submit the claim via electronically filing, by fax, or by mail. For claim adjudication, filings must include a copy of the Itemized Bill or HCFA and the Primary Carrier EOB.
What is Alliance Secondary plan's fee schedule and how do we join the network?
Alliance Secondary plan does not have a set network and does not require a contract between the healthcare provider and Alliance Secondary plan.
What is the Fee Schedule?
Why should I want to file this claim?
What does the future hold for healthcare providers?
With the affects of Healthcare Reform beginning to trickle down, one thing is for certain, your patient’s out-of-pocket expenses are increasing. This is going to further increase the amount of Accounts Receivable in the form of deductibles, copays, and coinsurance. Alliance Secondary plan will help you reduce this uncertainty.