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AFMC's Online Enrollment Verification Tool
| AFMC offers providers on-line patient enrollment verification.
This information DOES NOT guarantee coverage or payment, but rather indicates that the specified patient has access to AFMC for the date of service, according to enrollment records.
To verify benefits and eligibility, you MUST contact the Administrator listed on the enrollment screen or from the patient's health plan member ID card. To access online enrollment verification log onto www.azfmc.com, click on the "Provider" link then on "Enrollment Search."
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Administrators that Work with AFMC
| Do you know what administrators work with AFMC? It's easy to find out!
Simply visit the AFMC Web site and click on the "Get Administrator Listing" under the "Provider" link or click here. |
New Office Location?
New Phone or Fax Number?
Please let AFMC know!
| The AFMC Provider Change Form is a way for providers to keep AFMC informed about current practice information such as a change of address, Tax ID#, or specialty change.
Don't delay - download the form and fax, today!
Download form
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Put AFMC's Online Pre-Certification Request to Work for YOU!
| Arizona Foundation for Medical Care offers pre-certification services, which are designed to ensure that services provided to members are medically appropriate and provided in the appropriate setting, in addition to establishing  quality of care parameters. The goal of pre-certification is to ensure members receive the right care, in the right place, at the right time, and also reduce health claim costs.
The process is easy. First, confirm AFMC is performing utilization review for the employee by verifying the employee's ID card. In most cases, the information will appear on the back of the card, upper left-hand corner.
Situations that require pre-certification include, but are not limited to:
- A planned hospital admission more than 24 hours;
- An emergency or urgent hospital admission (notification to AFMC must occur within 24-48 hours of admission);
- Outpatient surgery;
- High-cost diagnostic procedures;
- Durable medical equipment; and/or
- Home care services.
Second - have the following information handy:
- Employee's full name, SSN or unique member ID#;
- Name of employer;
- Patient's full name, DOB, relationship to employee, address and phone number;
- Name of treatment facility, phone number and address;
- Reason for admission, OP surgery, diagnostic procedure, home health or DME;
- Planned admission/service date; and
- Clinical documentation or chart note.
Third, submit your request. When the review is completed, AFMC will notify the requestor of the results of the review via fax or phone, in addition to sending a notification to the insurance company/claims payor.
Should you have any questions or need assistance, the AFMC Provider Relations Team is here to help. Call or e-mail us: 800-624-4277 or providerrelations@azfmc.com. |
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NEW AFMC Presentation
Our Network Matters - Keeping Connected with AFMC Providers
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As a contracted provider, you serve a very important role in the delivery of healthcare services to the members of the employer groups we service. As such, the AFMC Provider Relations team has created a downloadable presentation as a supporting document to the Provider Reference Guide.
The Provider Reference Guide is intended as a guideline for the provision of your contract with AFMC, and contains information on how to conduct daily  business operations with us.
The presentation - Our Network Matters: Keeping Connected with AFMC Providers - is designed for newly contracted providers to help them navigate through AFMC requirements, or is a great refresher course for long-time members to the network.
Both documents are intended to serve as an orientation for Physicians, Allied Health Professionals and Facilities who have applied for membership in the Foundation and were accepted. The electronic formats were designed so providers could complete the orientation at a convenient time and download and print for future reference.
Satisfied providers are AFMC's most valuable resource and our best reference. Please let us know what we can do to sustain and improve our valued partnerships with you.
Should you have any questions about the information contained in the presentation or your Provider Reference Guide, please contact AFMC's Provider Relations Team.
Download Provider Presentation
Download Provider Reference Guide
Note: This link re-directs you to a secure area of the AFMC Web site. You will need an e-mail and password to log in.
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Hiring for Your Medical Practice's Culture
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Resumes for individuals applying for positions as nurses, medical assistants, billers and other medical practice staff may look similar within each job description. Applicants even might perform equally well in an interview. But  experience has told you that a candidate who looks great on paper can turn out to be a disastrous hire.
Why is that? The answer, experts say, comes down to cultural fit, the ability of an employee not merely to be able to do the job, but also to have the attitude and personality needed to work with others and further the goals of the practice.
"Landing the person [who] has all the elements that you need is a difficult process to get right even on the tangible measures that you can verify and/or test," said Geoffrey Patton, a practice management consultant based in Boston. "The intangibles, such as cultural fit, are the most difficult, and I challenge any manager with any degree of experience to tell you that they have gotten it right 100% of the time."
Read the full article...
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