FAQs
FAQs FOR CURRENT AHN PROVIDERS
Q: MY AHN PATIENT NEEDS IMAGING -- WHAT DO I DO?
A: Please fill out an AHN referral form detailing the type of imaging needed. Fax the referral form to AHN and we will process it. If you need an AHN referral form, you can download one here or call 1-877-384-2345 to have one faxed to you.
Download northern Nevada referral form
Download southern Nevada referral form
Download rural Nevada referral form
Q: MY AHN PATIENT NEEDS LAB WORK -- WHAT DO I DO?
A: Please fill out an AHN lab request form, keep one copy for yourself and give one copy to the patient. Directions to the labs are on the lab form.
Please DO NOT send any AHN patient to Lab Corps or Quest as we do not have contracts with those providers.
Q: WHAT DO I CHARGE MY AHN PATIENT?
A: It depends on their tier (see below). You can find the member’s tier number on their card. The member number begins with either T1 or T2, identifying the tier.
TIER 1 Provider Fees
Primary Care: Initial Consultation $60, Follow Up Care $40
Urgent Care: $70 per visit.
Specialty Care (Cardiology, Dermatology, Endocrinology, Gastroenterology, Gynecology, Infectious Disease, Neurology, Oncology, Ophthalmology, Oral Surgery, Orthopedic, ENT, Pathology, Ped Cardiology, Ped Endocrinology, Ped Neurology, Ped Pulmonolgy, Phys Med & Rehab, Plastic Surgery, Psychiatry, Pulmonology, Radiology, Rad Oncology, Rad Therapy, Rheumatology, Surgery, Urology) $130 Initial Consultation. Follow-up Care $65
Pharmacy: Significantly discounted
Dental (Exam, cleaning & x-rays): Clinic $65, Private Dentist $85
Hospital: $400 per diem in-patient all-inclusive, $3000 CAP. Intensive Care $600 per diem, $3000 Cap.
TIER 2 Provider Fees
Primary Care: Initial Consultation $70, Follow Up Care $45
Urgent Care: $70 per visit.
Specialty Care (Cardiology, Dermatology, Endocrinology, Gastroenterology, Gynecology, Infectious Disease, Neurology, Oncology, Ophthalmology, Oral Surgery, Orthopedic, ENT, Pathology, Ped Cardiology, Ped Endocrinology, Ped Neurology, Ped Pulmonolgy, Phys Med & Rehab, Plastic Surgery, Psychiatry, Pulmonology, Radiology, Rad Oncology, Rad Therapy, Rheumatology, Surgery, Urology) $140 Initial Consultation. Follow -up care $70
Pharmacy: Significantly discounted
Dental (Exam, cleaning, & X-rays): Clinic $75, Private Dentist $95.
Hospital: $400 per diem in-patient all-inclusive, $3000 cap. Intensive Care $600 per diem, $3000 Cap.
Q: MY AHN PATIENT NEEDS TO SEE A SPECIALIST -- WHAT DO I DO?
A: Please fill out an AHN referral form, including the type of specialist needed, and fax it to the AHN office. The patient’s care coordinator will process the referral. The referral will be faxed back to you so that you know which provider your patient was referred to.
Download northern Nevada referral form
Download southern Nevada referral form
Download rural Nevada referral form
Q: MY AHN PATIENT NEEDS SURGERY -- WHAT DO I DO?
A: Please fill out an AHN referral form including the CPT codes, date of surgery, length of surgery, surgery location and if there will be an assist and fax it to the AHN office. The patient’s care coordinator will process the referral and inform the patient and the provider of fees due to all providers associated with the surgery. The care coordinator will also make sure these fees are paid in advance of the procedure.
Download northern Nevada referral form
Download southern Nevada referral form
Download rural Nevada referral form
Q: THE PATIENT HAD AN IN-OFFICE PROCEDURE -- WHAT DO I CHARGE THEM?
A: To ensure the success of AHN, our members need to be well informed about how much they need to pay. When scheduling appointments for AHN members, please tell them what you expect the charges to be. For procedures, Tier 1 members should pay 50% of Medicare allowable for each CPT code involved, and Tier 2 members should pay 60% of Medicare allowable for each CPT code involved.
Minor office procedures – AHN asks that any minor procedure be included in the office visit fee.
Major office procedures – if a provider wishes to perform a major procedure on an AHN member, please schedule the procedure for a subsequent office visit if the member is not prepared to pay at that time.
When scheduling the appointment, be sure to inform the member of the exact cost of the procedure. For your convenience, the appropriate percentage of Medicare allowable is printed on each AHN member ID card.
Medicare allowable rates can be found at www.cms.hhs.gov/pfslookup
(Click on Physician Fee Schedule Search link)
Q: I SAW AN AHN PATIENT AS AN EMERGENCY AND THEY WERE NOT ABLE TO PAY AT THE TIME -- WHAT DO I DO?
A: Call the AHN office immediately. Identify the patient and ask for that patient’s Care Coordinator. The Care Coordinator will help you figure out payment and collect money from the member within five business days.
FAQs FOR POTENTIAL PROVIDERS
Q: WHAT IS ACCESS TO HEALTHCARE NETWORK?
A: AHN is a comprehensive network of hospitals, primary care and specialty care physicians, imaging services, labs, pharmacies, and other health care providers who offer their services to our uninsured working members at discounted fees in return for cash at the time of service.
Q: IS THIS AN INSURANCE PROGRAM?
A: No. AHN is a non-profit medical discount plan, fully registered with the State of Nevada and the Nevada Division of Insurance. AHN members pay for all of their own health care costs.
Q: HOW WILL I BE PAID?
A: You will be paid by the AHN patient at the time of service.
Q: DOES IT COST ANYTHING TO BECOME A PROVIDER FOR AHN?
A: No.
Q: HOW DO I BECOME A PROVIDER?
A: You can become a provider by calling our office and asking for our provider recruitment office. The process is quick and very easy.
Q: WHAT DO I DO IF I TAKE AN AHN MEMBER AS A PATIENT AND THEY NEED FURTHER CARE FROM ANOTHER TYPE OF PROVIDER?
A: AHN’s provider network is very extensive. You will have plenty of options for referring your AHN patients to any kind of care they need.
Q: WILL YOUR MEMBERS HAVE A PRIMARY CARE DOCTOR?
A: Yes. All AHN members are given a primary care physician when they enroll. All visits to specialists must be through referrals from that primary care provider.
Q: AM I LIABLE FOR PATIENTS I ACCEPT THROUGH AHN?
A: As with any patient, the provider holds the liability. However, AHN members all sign an agreement for binding arbitration when they enroll. If they have any kind of grievance with an AHN provider, they are obligated legally to follow our grievance procedure, which ends in binding arbitration.
Q: IF I SIGN UP TO BE A PROVIDER, WILL I GET MORE PATIENTS THAN I WANT TO HANDLE?
A: No. All of our providers have the option of limiting the number of patients they accept through AHN. We will send you as many or as few patients as you feel you can handle. You can change that number at any time.
Q: WHAT KINDS OF PATIENTS WILL I SEE THROUGH AHN?
A: You will see patients who do have an income and can pay for their care. People who cannot pay for their care are removed from the network, and are not allowed to re-enroll.
