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| Frequently Asked Questions |
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Q: How can our employees nominate their doctor for Arizona Foundation membership?
A: By completing the Provider Nomination Form located on this website.
Q: What is the procedure to set up a user ID and password?
A: If the option selected requires a Login, a screen will appear asking you to either login or register. If you have not yet registered, follow the steps for registration. Keep your User ID and password in a safe place for future reference. It will allow you to access your proprietary information.
Q: Our company has offices located in multiple locations across Arizona. Is it possible to provide them with a listing of doctors and facilities in their immediate area?
A: Yes, in Provider Search you can create a customized directory by plan type, county and/or city so that your employees will have the most current listing of providers in their area. The directory can also include all physicians and facilities. Your employees make it their own by selecting only the information they want.
Q: How can our employees check the status of their claim?
A: To check payment status, direct your employees to contact your company's Plan Administrator. Call the phone number for Benefits and Eligibility listed on their ID cards. To check repricing status, please contact AFMC customer service at (602) 252-4042 or (800) 624-4277.
NOTE: AFMC does not verify or provide health insurance benefits and/or eligibility, and we do not know what benefits your company's plan offers. AFMC does not pay claims. We are the network of providers and as such, we only re-price claims according to a predetermined fee schedule as described below.
Q: Who determines AFMC's physician fee schedule?
A: AFMC's discount structure is determined through contract negotiations with hospitals, surgical facilities, ancillary providers, and by an Independent Reimbursement Committee (IRC) that is responsible for setting the professional fees paid to physicians. The IRC is comprised of representatives that are elcted each year from employer groups using AFMC endorsed or sponsored plans and three non-member physicians. The Committee meets seevral times a year to review, amend, and set procedure allowances enabling AFMC to maintain our competitive edge in the marketplace.
Q: How long does it take to process a claim?
A: AFMC reprices clean claims in 1.5 days.
Q: Is AFMC compliant with current HIPAA regulations?
A: Yes, AFMC is HIPAA compliant.
Q: Who do I contact to learn more about AFMC networks?
A: AFMC's Senior Sales Consultants are available to answer questions and accommodate your requests. They can be reached at (602) 252-4042 or (800) 624-4277.
Q: What is the procedure to obtain a precertification (or preauthorization) for those services that require it?
A: To obtain precertification, direct your employees to follow the instructions printed on their ID cards.
Q: In what timeframe are the AFMC Providers contracted?
A: AFMC Providers are contracted on a calendar year basis (1/1 - 12/31). Providers contractually agree to remain in the AFMC network for the entire year ensuring network stability and continuity of care for your employees.
Q: How long has the Arizona Foundation for Medical Care (AFMC) network been in Arizona?
A: AFMC has been a PPO managed care network since 1969. AFMC is celebrating 40 years in 2009!
Q: If I participate in the Foundational Regional network, how can network status be checked?
A: Foundation Regional networks are available on this website.
NOTE: Members do not automatically have access to this network when using AFMC's Arizona network. Contact AFMC to verify access first. It is also recommended that a provider's network status be confirmed by calling the number printed on the member's ID card.
Q: Where can I find a list of insurance carriers that partner with AFMC?
A: A detailed listing of carriers that work with AFMC can be found in The Guide to AFMC's Fully Insured and Self-Funded Plans located on this website.
Q: Can AFMC accommodate employer groups with members outside of Arizona?
A: Yes, AFMC is a founding partner of VentureNet Healthcare, a regional coalition of four healthcare networks who have come together to offer members and corporate clients boundless access to high-quality, affordable healthcare across an eight state region.
By joining together to form this new entity, VentureNet Healthcare will be able to provide its members with access to more than 93,000 providers, 670 hospitals and 10,000 ancillary services across an eight state region including Alaska, Arizona, California, Idaho, Montana, Nevada, Oregon, Southwest Washington. This vast network will provide businesses that have multi-state operations in this region with a healthcare benefits packages that allows its members to access high-quality care anywhere in the region.
For more information about VentureNet Healthcare or for estimates on custom heath plans available for your clients, please call AFMC's Senior Sales Consultants at 602-252-4042, 800-624-4277, or e-mail them at info@venturenethc.com. Or, visit VentureNet Healthcare's Web site at http://www.venturenethc.com/
Q: How can our employees verify that a physician is an AFMC provider?
How can our employees find a physician, specialist, urgent care center, hospital or other facilities?
A: By using the Provider Search function on this website.
Q: What is the AFMF provider renewal rate?
A: AFMC has a 98% provider retention rate and contracts with providers for one year creating stability for members.
Q: How large is the provider network?
A: There are nearly 13,000 physicians with over 31,000 locations in AFMC's network. AFMC's Sr. Sales Consultants can provide you with our most current network numbers. They can be reached by calling 800-624-4277 or by clicking here.
Q: How can I obtain provider directories for our employees?
A: You can order provider directories online using the directory order form on this website.
Q: How are claims paid?
A: AFMC doesn't pay claims but reprices claims in accordance with a pre-determined fee schedule. Claim payment is made by the Plan Administrator.
Q: How are claims processed?
A: Over 75% of claims are auto-repriced electronically.
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