Working Together to Help Seniors
Welcome to Alignment Health Plan's Provider web page! At Alignment, we believe that the patient/physician relationship is an integral part of any treatment plan and want to work together to provide our members with the best quality of care possible. This portion of our website has been designed especially for our partners and their staff to assist with day-to-day operations. Additionally, it will provide important drug formulary information, medical disease treatment guidelines, and chronic care improvement programs.
Provider Portal Login
PPO Plan Information
Medicare Advantage PPO plans allow members to receive services from in-network providers and from out-of-network providers that participate in Medicare and agree to accept the plan. Like commercial PPO plans, providers do not have to be contracted with the Alignment Health Plan Medicare Advantage PPO plans to see Alignment PPO members.
For any assistance or information regarding member eligibility and access to disease management information, you can use the navigation under the Provider Resources tab. You will also be able to access Alignment Health Plan’s Provider Manual to reference our policies and procedures, as well as information and assistance with Risk Adjustment Factor (RAF) coding. RAF coding is crucial to the successful documentation of your member’s acute and chronic medical conditions and to comply with the Centers for Medicare & Medicaid Services (CMS) coding requirements.
Send your questions, inquiries, or comments to ProviderRelations@ahcusa.com. If you need to make changes to your provider network, please send an email to ProvData@ahcusa.com.
Interested in working with us?
For contracting opportunities, please send an email to ProvContr@ahcusa.com and include:
- Provider/entity name
- Service(s) provided
- State(s) where services are provided
- County/counties where services are provided
- Contact person and information
- Letter of intent and W-9 (attachment)
- National Provider Identifier number and Counsel for Affordable Quality Healthcare number (if applicable)