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Terms of Membership
Statement of Additional Terms of Membership
with American Dental Plan/ American Health Network
Your membership with American Dental Plan/ American Health
Network provides you with access to a network of participating
dentists, doctors, hospitals, labs, chiropractors, opticians and
other health care professionals who, by way of contractual
agreements, provide "discounted fees" for certain health
services. These participating healthcare locations are not employees
of American Health Network (AHN), nor does AHN have any control over
the operation of their practice. These health care offices are
independent of AHN, operate their own facility and manage their own
businesses. AHN does not in any way control, supervise, manage or
certify any independent health care location, dentist, or physician.
In order for any healthcare provider to participate with AHN they
must provide a copy of their current state license, carry minimum
amounts of malpractice liability insurance and agree to charge a
"discounted fee" for services in accordance with the applicable fee
schedule to our members. There can be no guarantee from AHN that the
information or services supplied by these providers is correct
or current. The independent providers have accepted full
responsibility for all services provided to our members, including
all billing, and agree to hold AHN harmless from any liability
from services performed by their office. If you have specific
questions regarding the backgrounds of any of the independent
participating providers, please contact the applicable State agency
that issues their license.
Your membership fee pays for the continual operation and
maintenance of the provider network and those costs such as; the
printing and issuance of your membership card, all printed sales and
support materials, postage, computer expense, payroll, office
utilities, related fees and taxes, webpage and all other
expenses that would be considered necessary to operate the
business. AHN does not reimburse any healthcare provider, nor
does it compensate any provider. AHN does not guarantee that
these independent health care providers will honor their written
agreement to provide a reduced fee for AHN members. AHN does not
receive any payment or notification from the healthcare provider
when you receive any health care services. All payments for services
are YOUR responsibility. Should you, the member, not pay the
provider upon receipt of services, you may be charged the usual
and customary fees, plus any collection costs and, therefore, not be
eligible for the reduced fee as stated in the brochure.
Should a participating location sell their business to
another provider, who may not become a provider on the Plan, AHN
cannot guarantee that you will be able to obtain health services in
accordance with the most recent fee schedule. Furthermore, should
you be billed for usual and customary fees from any non-provider,
you agree to hold AHN harmless from any actions created by this
billing activity, including all efforts to collect from a collection
agency.
Limited Cancellation Policy:
Your membership fee once received in our office, application processed and your ID cards issued, is deemed to be fully earned. There is no pro-ration of your membership fee nor any portion recognized as unearned or unused. The described services of AHN are limited to the acceptance of your application for membership, the issuance of an ID card and/or the notification of your membership status to the network of participating providers. Whether you use the benefits of AHN or allow time to expire without using the benefits, your membership fee is totally earned at the processing of your application. However, for the first 30 days following the processing of your application/renewal, should circumstances occur due to either an activity or error, you may request a refund of your paid membership fee, less a $35 processing fee, provided you have not used any benefits of the Plan during this period of time. Any requests for canceling memberships must be in writing and include the return of your ID cards.
Furthermore, AHN reserves the right not to accept your membership or renewal fee. The participating dentists and all providers of the Plan shall have the right to refuse treatment to any member who fails to follow a prescribed course of treatment.
American Health Network and its affiliated companies and plans
are not insurance and are not regulated by any State or Federal
Agency. By joining American Health Network, you accept the terms and
conditions described in this Statement of Additional Conditions and
all related fee schedules and printed materials. You understand that
the printed fee schedule may change without written notice. You
agree to hold AHN and its employees, agents and directors, harmless
from any actions caused, real or implied, by its participating
independent healthcare providers. Should you choose not to accept
the terms of membership, your application cannot be processed and
you are not able to join any of our health referral networks.
In addition to providing your name and address to AHN for purposes of joining our dental and healthcare plans, you allow American Dental Plan to enter your email address into it's data base for purposes of contacting you periodically for updates related to your membership and/or dental/medical related information. Please be assured that your information will not be sold or bartered with any other entity and will be used only for the sole purpose of your membership with American Dental Plan and American Health Network. At anytime, you can request to have your email information removed from our periodic newsletter.
Any comments or concerns can be directed to:
Board of Directors American Health Network P.O. Box
13254 Scottsdale, AZ 85267
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