Become a Participating Provider

America's 1st Choice Health Plans, Inc. is a health plan with a Medicare contract.  We offer Network PFFS plans and PPO plans in select counties of South Carolina. We have contracted a network of providers for our network products. Members must utilize a participating pharmacy for plans that offer Part D drug coverage except for urgent or emergent care.

To participate with our non-network PFFS plan, medical providers only need to be eligible to participate in Medicare and agree to accept our plan’s terms and conditions of payment (located below) each time they see our Presidential (PFFS) and Presidential Plus (PFFS) members, except in cases of urgent and emergent care.  These members’ plan benefits do not require authorizations, referrals, or other pre-cert notifications.  Providers can contact our provider relations team, claims center, or customer service directly. To obtain the contact information, Click Here.

To participate in our Network PFFS plan, medical providers may contact our plan to sign a direct contract with us, or participate as a non-contracted deemed provider if eligible to participate in Medicare and agree to accept our plans terms and conditions of payment (located below) each time they see our Patriot (PFFS) and Patriot Plus (PFFS) members, except in cases of urgent and emergent care.  Network PFFS plan members’ benefits do not require an authorization, pre-cert notification, or a referral.  Providers with questions can contact our provider relations team, claims center, or customer service departments directly. To obtain the contact information, Click Here.

To participate in our PPO network, medical providers may contact our plan to sign a direct contract with us. Medical providers may render services to our Ambassador Plus (PPO) members if eligible to participate in Medicare and accept Medicare allowable reimbursement, less the member’s cost-share.  Members will pay a higher cost share to see out of network providers except for urgent and emergent care.   PPO plan benefits may require an authorization, or pre-cert notification, but do not require a referral.  Please call the plan for details. To obtain the contact information, Click Here.

Thank you for your interest in working with America's 1st Choice. We look forward to a long and prosperous working relationship.

PFFS Terms and Conditions »
PFFS Claims and Reimbursement Information »

 

Last Updated: 08/28/2013