Company Overview

CONNECTING THE COMPANIES THAT CARE

While most healthcare experts tend to view healthcare as a national issue, the truth is that health care is a local issue - especially to the employees and dependents who utilize your healthcare benefits. The strength, stability and success of American Healthcare Alliance (AHA) is directly attributable to the fact that we are made up of locally and regionally sponsored Preferred Provider Organizations (PPOs).

We were founded in 1990 on the premise that, if local and regional preferred provider organizations could be linked together across the country through a single, centralized source, we could provide clients with access to local coverage on a nationwide basis. Since then, we have developed the largest independent alliance of such organizations in the United States, offering superior coverage even in rural areas.

Member networks are linked together through a uniform set of participation agreements focused on supporting the needs of your benefit plan, plan participant/insureds and providers. As a result, we can offer you access to one or all of our member networks coast to coast, effectively expanding covered service areas well beyond that which you could accomplish alone.

We have the ability to work with virtually any type of healthcare benefit program or payer, including:

  • Fully Insured
  • Self-Insured
  • Partially Self-Insured
  • Carrier Administered
  • Self-Administered
  • Third-Party Administered

In our role as a centralized contracting source, we act as the central point for implementation, program administration and customer service for our clients and preferred provider organizations. This centralization allows us to quickly respond to your needs, the needs of your plan participants/insureds and our PPOs.

Because of the unique format of our contractual agreements, you are able to capture preferred rates and fees based on the local or regional rates negotiated by the Preferred Provider System where services were delivered. This eliminates the need for a standard or nationwide fee schedule that might ignore potential savings in each individual market. Participating PPOs evaluate their preferred rates for services and adjust them as needed to remain competitive, efficient and cost-effective in their respective marketplaces.

NATIONWIDE COVERAGE FOR MAXIMUM FLEXIBILITY

We can provide coverage using the combined resources of more than 50 local and regional PPOs. Our participating PPOs include thousands of hospitals and hundreds of thousands of physicians and specialty providers across the United States. As our participating networks continue to grow, the number of providers and facilities may change from time to time.

To qualify for inclusion in the Alliance, PPOs must provide us with the criteria and standards used to select network providers in their area. This insures that all affiliated provider systems maintain the same high standards for service quality, accountability, customer service, cost effectiveness and stability.

YOUR SINGLE SOURCE FOR SERVICES

Thanks to our unique structure, multi-city, state, regional and national Employers, Insurance Carriers, Self-Insured Plans, and Partially Self-Insured Plans can participate in one or more of the participating AHA PPOs through a single contracting source. We are strategically located at the center of this contractual matrix, facilitating communication and interaction between participating PPOs and our clients, which enables us to simplify contracting, implementation and program administration.

This arrangement provides you with a number of advantages, including:
  • The ability to access multiple provider systems across the nation.
  • A single source for all PPO access fee remittance.
  • Access to locally sponsored PPOs, as opposed to national systems.
  • Uniform contractual agreements that simplify maintenance of multiple PPO relationships.
  • Provider system reciprocity through the AHA-USA Reciprocity Program, which allows you to offer expanded, national coverage for eligible employees and dependents who are traveling.
OUR MISSION
  • American Healthcare Alliance is dedicated to providing our clients with access to quality, cost-effective healthcare services on a nationwide basis through contractual agreements with local and regional Preferred Provider Organizations.
OUR OBJECTIVES
  • To help clients obtain quality healthcare services through preferred provider organizations committed to helping them stabilize their healthcare expenditures.
  • To act as a centralized contracting source through which clients may access local and regional preferred provider organizations nationwide.
  • To promote and maintain a spirit of cooperation and communication.
  • To strive to meet the needs of our clients, their plan participants/insureds, and the participating provider systems.
  • To keep implementation and administration of AHA programs user-friendly without compromising the integrity and objectives of our clients and providers.
  • To provide clients and participating provider systems with exceptional customer service.
  • To treat each AHA client and provider system with the respect and dignity they expect and deserve.

Because we know how important confidentiality is to you, we place a high priority on security and patient information, regardless of whether data is transferred electronically or by mail or fax. In fact, AHA utilizes the latest, most effective security technology to protect the privacy of Protected Healthcare Information as set forth by the federal government. We are also HIPAA compliant and certified with respect to the electronic transmission of healthcare claims and information as set forth under the latest ASC X12N 837 (004010X098) guidelines.

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