For Providers



Health Care Provider Responsibilities:

● Coordinate with Anchorage Project Access for patient’s follow up medical treatment plan. Fax the Patient Follow-Up Form to (907) 646-0542 or secure email to assigned Care Coordinator.

● Medical: Complete HCFA 1500 Form using Policy Group AK200 in Box 11 and send to:

Meritain Health

PO Box 853921

Richardson, TX 75085-3921

EDI: WebMD: #41124 Group AK200

Fax: (763) 852-5057

Meritain Health only collects the medical data and reports on the value of donated care to APA. There is no reimbursement for services as they are donated per the providers signed Health Care Provider Participation Form.

● Dental: Complete Dental Claim Form and fax or email to:

Anchorage Project Access

3340 Providence Dr Ste A307

Anchorage, AK 99508

Fax: (907) 646-0542

APA is tracking the value of donated care only. There is no reimbursement for services as they are donated per the providers signed Dental Provider Participation Form.

● Mental Health: Complete and return the bottom section of the therapy appointment request form to:

Stephanie Richardson

Pro Bono Counseling Program Manager

Fax: (907) 646-0542

Phone: (907) 743-6652

APA is tracking the value of donated care only. There is no reimbursement for services as they are donated per the providers signed Pro Bono Counseling Provider Participation Form.

Patient Care Coordinator Responsibilities:

● Contact the health care provider’s office directly to schedule the initial appointment.

● Enter patient referral into our database. The database enables APA to track each referral the health care provider accepts.

● Provide a patient appointment reminder call the day before their appointment.

● Follow up with patient after the appointment date to confirm the appointment was kept and discuss patient’s understanding of their treatment plan. APA patients understand they cannot miss their appointments and must comply with their treatment plans. Failure to do so will disqualify the patient from the program.

● Notify patient that their enrollment has expired. A patient’s enrollment period may be extended if the patient’s treatment plan is not completed.

Patient Pharmacy Benefit:

● Patients are assigned a pharmacy home.

● Patients may pay $5 co-pay for each prescription. Co-pay is applied to the cost of the pharmaceutical.

● Generic substitution will apply to all prescriptions unless notated.

● Patients have an $800 limit of pharmaceuticals benefit per calendar year.

● All prescriptions must have “For Anchorage Project Access” written on them in the providers’ handwriting.

● There is no prescription support for dental services.