Provider Services
Alliance Secondary InsuranceBenefits to Providers
For services eligible under the patients’ primary health insurance, Alliance Secondary Insurance pays the patients’ out-of-pocket expenses such as copays, deductibles, and coinsurance. Claims are paid directly to the healthcare provider via our third party administrator HealthComp, LLC. Alliance Secondary Insurance provides many benefits to healthcare providers such as, but not limited to
Reduction in Accounts Receivable.
Reduction in the volume of patient services that are delayed or avoided.
Increase in patient utilization.
Improvement in patient’s physical and financial wellbeing.
Claims Process
One of the unique advantages of Alliance Secondary Insurance 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.
Claim Filing
Provider to include 1. Itemized Bill or HCFA Form 2. Copy of Primary Carrier EOB and 3. Electronic Payor ID# 07205
Verify Coverage Online:
or register to the provider portal.
Verify Coverage
(844) 413-2681
US Mail Claims Submissions
Personify Health
PO Box 660091
Dallas, TX 75266-009
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:
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.
Electronic filings are made to Personify Health with Electronic Payer ID#07205 and mailed claims are made to Personify Health: PO Box 660091 Dallas, TX 75266-0091. With all available methods, healthcare providers must include a copy of the Primary Carrier EOB and Itemized Statement or HCFA.
What is Alliance Secondary Insurance’s fee schedule and how do we join the network?
Alliance Secondary Insurance does not have a set network and does not require a contract between the healthcare provider and Alliance Secondary Insurance.
What is the Fee Schedule?
There is no fee schedule. We pay the patient’s portion of the claim (i.e., copays, deductible, and coinsurance) directly to the providers on a dollar-for-dollar basis. The amount that the patient owes is determined by the underlying primary insurance carrier’s contract and can be found on the primary carrier’s EOB.
Why should I want to file this claim?
Most importantly, it will keep your patients happy and insure that they continue to return to your practice for care. From a claims perspective, it will reduce the amount of uncollected Accounts Receivable by shifting the claims to a highly rated insurance company verses an individual.
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 Insurance will help you reduce this uncertainty.