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Why
choose
AmeriPlan®?
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AmeriPlan®
is
the
nation's
premier
Provider
Access
Organization,
saving
its
members
hundreds
of
millions
of
dollars
in
supplemental
health
benefits
since
1992.
AmeriPlan®
is
the
largest
referral
fee-for-services
plan
in
the
country.
Our
track
record
of
success
in
providing
access
to
affordable
supplemental
health
benefits
speaks
for
itself.
We
know
our
business.
AmeriPlan®
is
a
member
in
good
standing
with
the
United
States
Chamber
of
Commerce,
the
American
Academy
of
Group
Dental
Practices,
the
National
Association
of
Dental
Plans,
the
National
Association
of
Provider
Access
Organizations,
and
the
Consumer
Health
Alliance.
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Who
is
AmeriPlan®?
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AmeriPlan®
is
a
Nationwide
Provider
Access
Organization.
We
arrange
for
our
members
to
have
access
to
physicians,
ancillary
services,
hospital
advocacy,
dental,
vision,
prescription
drug
and
chiropractic
providers
who
have
agreed
to
offer
their
services
at
negotiated
discounts
off
their
usual
and
customary
fees.
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What
is
AmeriPlan®
Dental
Care?
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AmeriPlan®
Dental
Care
is
a
Discount
Medical
Program
Organization
that
offers
memberships
in
its
discount
dental
program.
Members
can
save
25%
to
65%
on
all
restorative
and
cosmetic
work
(fillings,
crowns,
braces,
etc.)
and
up
to
80%
on
preventative
work
(teeth
cleaning,
x-rays,
etc.)
performed
by
a
general
dentist.
Specialist
fees
are
discounted
20
-
25%.
Since
the
dental
program
is
not
insurance
or
a
health care
organization,
all
ongoing
dental
problems
are
accepted
except
orthodontic
treatment
in
progress.
Instant
Savings,
no
paper
work
to
fill
out
and
no
limits
on
visits
to
your
dentist. |
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How
does
the
plan
work?
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With
your
Dental
Plan
membership,
you
will
have
access
to
dental
providers
who
have
agreed
to
offer
their
services
at
negotiated
discounts
off
of
what
they
usually
charge.
For
the
same
quality
care,
you
pay
members-only
discounted
prices
at
the
time
of
service.
No
paper
work
is
needed.
To
locate
a
dentist
near
you,
please
Click
here.
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Is
this
Health
Insurance?
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No.
This
is
a
non-insurance,
reduced
fee-for-service
Dental/Medical
Plan.
Members
receive
discounts
based
on
our
group's
aggregated
purchasing
power.
The
out-of-pocket
payments
you
make
to
the
dentist
are
based
on
a
members-only
discounted
fee
schedule.
Other
advantages
of
being
our
Dental/Medical
Plan
member
is
that
there
is
no
waiting
periods,
instant
savings,
no
paper
work,
no
age
limits.
All
ongoing
dental/medical
problems
are
accepted
except
orthodontic
treatment
in
progress.
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How
soon
can
I
use
the
dental
benefits?
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Once
you
sign
up
online
or
over
the
phone,
your
membership
will
be
activated
within
one
business
day.
You
then
become
eligible
for
all
dental
benefits.
All
ongoing
problems
are
included,
except
for
orthodontic
treatment
in
progress.
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How
do
I
sign
up?
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You
can
sign
up
7
days
a
week,
24
hours
a
day:
Online
-Click
here
Your
application
will
be
safely
submitted
via
secure
servers.
Phone
-
877-414-1167.
We
accept
all
major
credit
cards
or
checks.
Regular
mail
-
Click
here
to
have
an
application
sent
to
you.
We
accept
all
major
Credit
Cards
and
Checks.
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What
is
the
discount
members
receive
on
dental
fees?
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Members
can
save
20%-65%
on
all
restorative
and
cosmetic
work
(fillings,
crowns,
braces,
etc.)
and
up
to
80%
on
preventative
work
(teeth
cleaning,
x-rays,
etc.)
performed
by
a
general
dentist.
Specialist
fees
are
discounted
15%-25%.
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How
much
is
the
Dental
Program
(DVPC)
membership
fee?
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- An Individual or Entire household membership is $19.95 per month.
- Family membership includes all residents in the household including parents, children, relatives, significant others and all permanent residents of the household.
-
There
is
a
one-time
only
$20
application
fee.
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Are
there
any
limits
on
the
type
of
services
included? |
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There
are
no
limits
whatsoever.
There
are
no
yearly
maximums.
You
can
go
to
the
dentist
as
often
as
you
like
and
always
get
services
you
need
at
discounted
prices.
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How
do
I
pay
my
Membership
Fee?
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Monthly
or
quarterly
payments
are
made
ONLY
by
electronic
bank
draft
or
by
credit
card.
INVOICING
IS
DONE
ONLY
FOR
ANNUAL
MEMBERSHIPS
PAID
ONE
YEAR
IN
ADVANCE. |
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How
much
more
do
the
pharmacy,
vision
and
chiropractic
benefits
cost?
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The
prescription
drug,
vision
and
chiropractic
benefits
are
included
at
no
extra
cost
with
the
dental
plan
membership.
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Who
are
the
Dental,
Pharmacy,
Vision
and
Chiropractic
Care
providers?
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Your
membership
welcome
package
will
contain
a
directory
of
the
providers.
AmeriPlan®
Dental
Care
has
assembled
one
of
the
largest
networks
of
dental
providers
in
the
nation,
and
we
are
continually
adding
to
this
base.
These
dentists
are
well
established,
with
successful
dental
practices.
Nationwide,
there
are
more
than
25,000
dental
providers.
Our
prescription
card
may
be
used
at
our
participating
pharmacies
nationwide,
as
well
as
through
mail
order.
The
vision
care
benefits
are
available
nationwide
at
more
than
12,000
providers,
and
our
chiropractic
benefits
may
be
used
with
more
than
7,500
credentialed
chiropractors.
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How
do
I
use
the
benefits?
Will
I
be
sent
a
membership
information
package?
What
type
of
customer
support
do
you
offer
to
members?
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Within
10
to
14
working
days
of
receipt
of
your
application,
you
will
receive
a
Member
Information
Guide,
Membership
Identification
Cards
and
a
Dental,
Pharmacy,
Vision
and
Chiropractic
Care
Directory.
Before
your
first
Medical
office
visit,
simply
call
the
toll-free
number
on
the
back
of
your
card
and
our
customer
service
department
will
help
coordinate
your
office
visit.
Present
your
Identification
Card
to
any
AmeriPlan®
provider
and
you
will
be
eligible
to
get
the
discounted
fees.
You
pay
the
provider
at
the
time
of
service.
All
members
can
also
access
a
toll
free
members'
support
hotline
on
the
back
of
your
membership
card with
customer
service
representatives
who
are
ready
to
help
you
out.
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What
if
I
want
to
go
to
a
specific
dentist
who
is
currently
not
within
your
network? |
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You
will
enjoy
the
Plan
discounts
only
when
you
see
a
dentist
within
our
network.
You
may
choose
to
refer
your
dentist
to
join
the
AmeriPlan®
network.
Please
contact
us
for
details.
You
may
also
us
the
provider
nomination
form
in
the
back
of
your
member
information
guide.
Please
be
assured
that
all
dentists
currently
within
our
network
are
fully
credentialed.
Their
offices
have
been
inspected
and
comply
with AmeriPlan®'s
high
standards.
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I
already
have
dental
insurance
through
work.
Can
I
still
sign
up
for
this
Plan?
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Yes,
you
can
sign
up
and
use
this
Dental
Plan
even
if
you
are
a
member
of
other
Dental
Insurance
Plans.
As
an
example,
the
additional
benefits
of
our
Plan
will
help
to
reduce
your
out-of-pocket
expenses
substantially
when
your
insurance
benefits
have
been
exhausted. |
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How
do
I
locate
an
AmeriPlan
Health®
provider?
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There
are
three
ways
to
locate
a
provider.
Instructions
are
included
in
the
Member
Information
Guide
that
you
will
receive
with
your
identification
cards.
A
directory
of
providers
will
be
mailed
to
all
Dental
Plan
members
as
part
of
your
Member
Information
Guide.
Nationwide,
there
are
more
than
30,000
dental
providers,
50,000
pharmacies,
12,000
vision
care
providers
and
7,000
chiropractors
on
our
plan.
They
are:
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How
can
I
refer
my
personal
physician
to
AmeriPlan®?
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If
a
member
calls
the
AmeriPlan
Health®
Customer
Service
number
(800-472-3995)
the
referral
will
be
taken
over
the
phone
or
the
referral
can
be
faxed.
A
patient’s
name
must
always
be
associated
with
provider
referrals.
The
procedure
for
referring
physicians
is
the
same
as
for
referring
dentists
and
chiropractors.
Every
member
is
given
the
referral
forms
in
the
New
Member
Packet
that
is
similar
to
the
dental
referral
card.
A
member
may
also
send
a
referral
to
referral@ameriplanusa.com.
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Can
I
purchase
the
medical
plan
without
the
DVPC
Plus
plan included?
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No.
Presently
in
most
states,
the
medical
plan
is
only
sold
as
a
unit
with
AmeriPlan
Dental
Plus™.
Florida
is
the
only
exception,
where
the
medical
plan
is
sold
separately
due
to
state
regulations.
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Can
I
downgrade
from
AmeriPlan
Health®
to
the
Dental
Plus Program?
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Yes.
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Can
anyone
join
AmeriPlan
Health®?
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Yes.
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Can
AmeriPlan
Health®
Benefits
be
used
with
Medicare/Medicaid?
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No.
Medicare
does
not
allow
their
providers
to
charge
a
Medicare
patient
a
different
price.
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Are
doctors
reimbursed
by
AmeriPlan®
for
their
services?
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No.
As
with
all
of
our
health
benefits,
the
provider
receives
the
full
discounted
fee
from
the
member
at
the
time
services
are
rendered.
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Do
the
providers
understand
that
we
must
pay
at
the
time
services
are
rendered?
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When
the
verification
call
is
placed
to
the
physician’s
office,
the
AmeriPlan
Health®
Customer
Service
Representative
will
tell
the
provider
they
must
call
to
reprice
the
bill
over
the
phone
and
they
should
collect
payment
at
the
time
of
the
visit.
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Why
would
a
medical
professional
want
to
participate
in
the
AmeriPlan®
Consumer
Driven
Health
Care
(CDHC)
Program?
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There
are
many
reasons,
the
most
important
are:
- Patient care and treatment is put back into the physician’s hands.
- Economic Advantages
- The provider gets paid at the time of care. Most insurance plans make the physician wait up to 120 days for payment.
- Office administrative costs are reduced.
- - No paper work to complete.
- - No paper work to file and follow-up.
- - No invoices to issue to patient or third-party payer
- Net increase in revenue vs. insurance HMO or PPO.
- The provider is part of an affiliation of like-minded professionals, without being “under the thumb” of managed care.
- AmeriPlan Health® is the New Medicine – the wave of the future, providing members with comprehensive, quality, discounted healthcare.
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Do
I
have
to
pay
when
I
am
in
the
office?
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YES.
The
member
shall
pay
in
full
at
the
time
services
are
rendered.
The
office
will
call
the
AmeriPlan
Health®
repricing
agents,
who
will
conduct
a
phone
repricing
and
tell
the
office
staff
how
much
to
collect
from
the
member
once
the
discounts
have
been
applied.
The
agent
will
then
fax
the
repriced
claim
to
the
provider’s
office
and
mail
an
Explanation
of
Benefits
(EOB)
to
the
provider
and
the
member.
This
way
the
member
can
have
documentation
of
their
discounted
pricing.
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What
is
an
EOB?
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An
E.O.B.
is
an
insurance
industry
acronym
abbreviation
for
Explanation
of
Benefits
or
E.O.B.
This
is
a
statement
of
benefits
which
lists
the
codes
of
the
procedures
performed
at
the
office,
along
with
normal
fees
and
the
amount
the
member
saved.
Members
receive
these
statements
from
the
providers’
offices
following
their
visit.
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When
I
arrive
for
my
appointment,
how
do
you
ensure
the
provider
will
understand
how
the
plan
works?
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The
Customer
Service
Representative
will
call
the
provider’s
office
prior
to
the
member’s
appointment
to
ensure
that
the
doctor
is
accepting
new
patients,
to
make
sure
they
understand
that
the
members
are
self-pay
at
the
time
of
service
and
to
contact
the
repricing
agent
for
assistance
with
the
bill.
A
fax
is
sent
to
the
physician’s
office
as
a
follow-up.
In
addition,
the
Customer
Service
number
is
on
the
member’s
ID
card,
and
the
provider
is
welcome
to
contact
Customer
Service
if
they
have
any
questions
on
the
program.
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If
a
member
wants
to
know
if
their
doctor
is
currently
in
the
network.
How
will
Customer
Service
determine
this
and
what
will
they
tell
the
member?
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A
database
of
network
medical
providers
is
maintained
and
available
to
AmeriPlan
Health®
members.
(This
is
also
available
on
the
website.)
The
Customer
Service
Representative
can
search
for
a
desired
provider
by
name,
specialty,
and
a
local
zip
code.
If
the
provider
is
in
network,
the
Customer
Service
Representative
will
ask
if
they
plan
on
visiting
said
provider.
If
so,
Customer
Service
will
contact
the
provider’s
office
on
behalf
of
the
member.
If
the
doctor
is
not
part
of
the
network,
they
will
offer
the
member
another
provider
in
the
same
specialty
and
area.
This
is
done
so
that
the
member
may
make
the
most
of
the
program.
The
member
can
also
submit
a
Provider
Referral/Nomination
form
so
that
they
can
refer/nominate
their
doctor,
who
will
then
be
contacted
regarding
joining
the
AmeriPlan
Health®
network.
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How
often
do
you
check
with
providers
to
see
if
they
are
still
participating
in
your
program?
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The
Customer
Service
Representatives
will
call
the
provider’s
office
prior
to
sending
the
member
to
see
him/her,
and
verify
that
they
are
accepting
new
patients
and
still
participating
in
the
program.
The
only
exception
would
be
if
the
provider
has
already
confirmed
within
the
previous
90
days.
In
this
situation,
a
fax
is
sent
to
the
office
letting
them
know
the
member
will
be
calling
to
make
an
appointment
and
reiterating
how
the
program
works.
If
the
previous
verification
was
completed
more
than
90
days
ago,
the
Customer
Service
Representative
will
call
the
doctor’s
office
and
speak
to
someone
again
to
verify
that
they
are:
- accepting new patients
- are still participating in AmeriPlan Health® and
- they know to contact the repricing agent for repricing of the fees
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What
do
I
do
when
I
need
to
see
a
physician?
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- Member must call AmeriPlan® Customer Service and verify the provider is in network.
- Customer Service will call member back. (This could take up to 48 hours on non-emergency needs.)
- Member may be directed immediately to a network providers’ office or will be called back with verification.
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Might
there
be
areas
with
very
few
providers?
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There
will
be
some
secondary
type
markets
with
minimal
or
no
providers.
There
should
not
be
any
major
markets
with
the
same
issue.
We
have
access
to
the
largest
number
of
“Discount”
providers
of
any
program
offered.
However,
there
are
only
a
limited
number
of
“Discount”
medical
providers
in
the
U.S.
In
a
continued
effort
to
provide
our
members
and
Brokers/IBOs
with
the
best
program
available,
we
will
be
continuously
analyzing
various
areas
to
see
if
we
need
to
“plug
in”
one
of
our
other
networks.
Were
are
not
doing
business
in
Vermont,
Wyoming,
Montana,
North
Dakota
and
South
Dakota. |
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If
the
doctor’s
office
has
lab
facilities,
can
these
be
utilized
rather
than
having
to
go
to
another
lab?
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Yes.
The
lab
services
will
be
billed
at
the
contracted
network
discount.
|
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Do
I
receive
a
fee
schedule
for
AmeriPlan
Health®?
|
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|
No.
Fees
will
vary
by
zip
code.
|
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|
Do
I
receive
a
separate
card
for
AmeriPlan
Health®?
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Approved
members
receive
four
cards:
two
AmeriPlan
Health®
(CDHC)
ID
cards
and
two
Dental
Program
(DVPC)
cards.
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What
is
the
difference
between
a
limited
patient
visit,
an
intermediate
visit
and
an
extended
visit?
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A
limited
patient
visit
is
one
where
the
member
is
seen
for
a
problem-focused
visit
with
minor
problems
(physician
time
10
minutes),
i.e.
recheck
for
a
cold.
An
intermediate
patient
visit
is
more
involved
with
low
to
moderate
severity,
and
will
require
a
longer
visit
with
the
provider,
i.e.
sore
throat.
An
extended
patient
visit
is
where
the
member
is
having
a
physical
examination
or
consultation
for
a
chronic
illness
or
consideration
for
surgery,
etc.
(moderate
to
high
severity).
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Are
ongoing
dental/medical
problems
(conditions)
covered?
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Since
AmeriPlan®
is
NOT
INSURANCE
OR
A
HEALTH
ORGANIZATION,
all
ongoing
dental/medical
problems
(conditions)
are
accepted
for
contracted
treatment
plans
including
orthodontic
treatment
in
progress.
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Will
maternity
be
included?
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All
medical
needs
are
included
as
long
as
we
have
contracted
providers
offering
this
service.
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Will
my
privacy
be
protected?
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Yes.
AmeriPlan®
is
compliant
with
all
HIPAA
regulations.
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Does
medical
include
hearing
tests
and
hearing
aids?
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Yes.
Hearing
Services
will
be
included
under
our
Ancillary
Services
providers.
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Is
there
a
waiting
period
for
new
members?
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No.
Members
can
use
the
program
as
soon
as
they
receive
their
membership
cards.
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Is
there
a
deductible
to
be
met
from
any
of
the
health
benefits?
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There
are
no
paper
work
to
fill
out,
instant
savings
and
no
limits
on
visits
to
AmeriPlan®
network
providers.
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Will
all
areas
have
specialists
and
ancillary
services?
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Yes.
However,
some
specialists
and
ancillary
providers
may
not
be
available
in
a
particular
geographic
region.
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Can
AmeriPlan
Health
®
(CDHC)
be
used
in
conjunction
with
health
insurance
plans?
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Yes
it
can,
but
it
is
always
at
the
Doctor's
discretion
to
accept
both.
As
with
our
Dental
Program
(DVPC)
benefits,
your
insurance
should
always
be
the
primary
payment
form.
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How
is
the
discounted
fee
calculated
with
the
Medical
Program
(CDHC)?
Are
fees
still
calculated
based
on
Medicare
fees?
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The
rates
that
the
provider
will
charge
are
determined
based
upon
either
a
set
fee
schedule
that
the
provider
has
contracted
with
the
physician
network,
or
as
a
percentage
off
of
their
billed
charges.
In
general,
discounts
will
vary
between
20%
–
50%.
Labs
and
Diagnostics
will
have
discounts
of
up
to
80%.
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Can
I
pay
with
cash,
personal
check
or
personal
credit
card
for
services?
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Yes.
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Is
the
Total
Health
Discount
Programs
(CDHC)
contract
on
an
annual
basis
and
cancelable
at
any
time,
like
the
Dental
Plus Program
(DVPC)?
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Yes.
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Do
I
have
a
choice
of
which
hospital
will
be
used?
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Yes.
The
Hospital
Advocacy
Representative
will
negotiate
with
any
hospital
of
the
member’s
choice.
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Are
there
benefits
for
emergency
services?
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Yes.
Emergency
services
may
or
may
not
be
contracted
with
AmeriPlan
Health®.
Depending
on
the
extent
of
the
charges,
these
services
may
be
eligible
for
the
Hospital
Advocacy
Program.
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How
does
the
Hospital
Advocacy
Program
work?
Can
you
please
explain
the
Karis
(Hospital
Advocacy)
program
and
what
the
discount
percentage
will
be?
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The
Hospital
Advocacy
Program
will
stay
exactly
the
same.
The
service
is
designed
to
help
members
with
their
medical
bills,
which
total
$2,500
for
a
single
incident.
Charges
can
be
incurred
from
multiple
providers.
The
patient
advocate
pursues
a
wide
range
of
options,
from
government
entitlement
programs
to
negotiating
settlements
and
payment
plans.
NOTE:
The
percentage
saved
varies
on
a
case-by-case
basis.
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What
if
I
move?
What
if
I
or
someone
in
my
household
travels
out
of
state?
Can
we
still
use
the
Plan?
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Yes,
any
Plan
member
can
use
his
or
her
Plan
benefits
with
all
providers
in
our
nationwide
network
-
regardless
of
his
or
her
state
of
residence.
AmeriPlan®
providers
are
available
US
nationwide
(except
Alaska,
Vermont,
Wyoming,
Montana,
North
Dakota
and
South
Dakota.).
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Will
members
receive
a
guaranteed
discount?
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All
members
should
receive
a
20%
“minimal
discount”.
If
a
20%
“minimal
discount”
is
not
received,
the
member
should
call
into
Member
Services
and
file
the
appropriate
paperwork
so
the
issue
can
be
researched
and
resolved.
All
members
will
receive
an
EOB
mailed
to
them
which
will
have
the
discounted
amount.
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Please
explain
your
100%
satisfaction
guarantee.
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If
you
are
not
satisfied
within
the
first
30
days
of
becoming
a
member,
you
may
cancel
your
membership
in
writing
by
mail
to
5700
Democracy
Drive,
Plano,
Texas
75024,
fax
to
(469)
229-4595
or
e-mail
to
stop@stopmembership.com .
Your
membership
fee
will
be
refunded.
Please
be
aware
that
the
one-time
application
fee
and
money
paid
for
health care
services
and
products
are
not
refundable.
After
30
days
membership
fees
are
not-refundable.
You
may
cancel
your
membership
at
any
time
upon
written
request
to
AmeriPlan®.
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