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Provider Services

Alliance Secondary Health

Claims Filing

Provider Verifying Coverage

OptiMed Phone Number:
(800) 482-8770

US Mail Claims Submissions

OptiMed Health Plans
3145 Avalon Ridge PL Suite 300
Peachtree Corners, GA 30071-1543

EDI Claims Submissions

Clearing House: Change Healthcare
Payor ID: 96277
Phone Number: (800) 482-8770

Provider Filing Claims Must Include

  1. Itemized Bill or HCFA Form
  2. Copy of Primary Carrier EOB
claims process

Provider Portal

Click the button below to access or register to the provider portal:

Provider Portal

Provider Portal

Benefits to Providers

For services eligible under the patients’ primary health insurance, the Alliance Secondary Health plan administrator, United Group Programs, processes the claims for the patients’ out-of-pocket expenses such as copays, deductibles, and coinsurance. Claims are paid directly to the healthcare provider (unless the insured elects to not assign benefits to the provider).  Alliance Secondary Health can offer many benefits to healthcare providers such as, but not limited to:

  • Timely direct deposit payments.
  • Reduction in Accounts Receivable.
  • Reduction in the volume patient services that are delayed or avoided.
  • Reduction in bad debt.
  • Increase in patient utilization.
  • Improvement in patient’s physical and financial wellbeing.

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 OptiMed with clearing house Smart Data Solutions Payor ID# UGP19 and mailed claims are made to OptiMed Health Plans; 4 Terry Drive, Suite 1; Newtown, PA 18940. With all available methods, healthcare providers must include a copy of the Primary Carrier EOB and Itemized Statement or HCFA.

What is Alliance Secondary Health’s fee schedule and how do we join the network?
There is no network with the Alliance Secondary Health product and the insured may go to any provider.  There is no required contract between healthcare providers and the Alliance Secondary Health product.
What is the Fee Schedule?
There is no fee schedule.  The plan administrator, United Group Programs, processes the patient’s portion of the claim (i.e., copays, deductible, and coinsurance), subject to the plan’s limitations and exclusions.  The amount that the patient owes is determined by the underlying primary insurance carrier’s policy 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 return to your practice for care.  From a claims perspective, it could reduce the amount of uncollected Accounts Receivable.
What does the future hold for healthcare providers?
With the affects of Healthcare Reform, one thing is for certain, your patient’s out-of-pocket expenses will likely be increasing. This could further increase the amount of Accounts Receivable in the form of deductibles, copays, and coinsurance.  Alliance Secondary Health may help you reduce this uncertainty.

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