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Precertification of Elective Hospital Admission
When a physician determines treatment may require a hospital stay, it is the member’s responsibility to advise the physician of the need to pre-certify the service. This is called "pre-certification." If you do not obtain pre-certification, benefits may be reduced or denied which could result in higher out-of-pocket costs. Charges for any services excluded under the health insurance plan are the responsibility of the patient/insured.
Please be certain to verify the specific precertification guidelines with your plan administrator, insurance company and/or your human resource/benefits representative. Refer to your ID card for the contact information, which is usually located on the back of the card. Remember: AFMC does not verify benefits or eligibility.
Search for a Provider
The most convenient method to find a doctor, hospital or other healthcare service provider in the AFMC Network is by using our provider search and custom directory tools via this website. The provider search includes the most detailed provider information available and is updated regularly. Access to our provider search online is available 24/7, 365 days a year. The custom directory tool allows you to create your own provider directory that includes only the information you want and can be printed on demand. Or you may contact us and speak with a call center representative who can assist you in locating a provider. |
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Your Health Information Is Protected By Federal Law
Most of us believe that our medical and other health information is private and should be protected, and we want to know who has this information. The Privacy Rule, a Federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information. The Privacy Rule applies to all forms of individuals' protected health information, whether electronic, written, or oral. The Security Rule, a Federal law that protects health information in electronic form, requires entities covered by HIPAA to ensure that electronic protected health information is secure. Learn more.
The links below are pdfs. You must have the latest version Adobe Reader installed on your computer to view these files.
Member ID Card 101 - Learn more about AFMC Member ID Cards and how they should be used.
Providers and Their Definitions - Definitions of different types of specialists.
Choosing Your Healthcare Provider - Tips on how to choose the best doctor to fit you and your families healthcare needs.
ER vs Urgent Care - Tips on when to visit an Emergency Room and/or an Urgent Care Center.
Guide to Health Insurance Jargon - There are many acronymns in healthcare; this tip sheet explains a few of them.
Hospital Safe Stay Strategies - Tips to help guide you and loved ones through a hospital stay.
A routine checkup from a healthcare provider is a good way to find out your health status; ask questions about your health; and discover if you have a health problem you may not know about. The basic parts of a checkup can include:
- A complete medical history, including family health history, past illnesses, and current health problems.
- A check on how well your eyes, ears, heart, bowels, etc. function.
- A check of your blood pressure, pulse, temperature, etc.
- A medical exam, which can include routine tests such as a blood test, cholesteral blood test, diabetes screening, chest x-ray, to name a few.
- A check of specific health concerns.
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