CLAIMS INFORMATION

CLAIMS SUBMISSION

PAPER CLAIMS SUBMISSION ADDRESS
Network Medical Management
1600 Corporate Center Drive, Suite 106
Monterey Park, CA 91754

Beginning January 1, 2020, AAMG may no longer be accepting paper claims, EXCEPT for the ones listed as exceptions. Some of these exceptions include:

  • Small provider claims

  • Claims from providers that submit fewer than 10 claims per month on average during a calendar year

  • Claims for payment under a Medicare demonstration project that specifies paper submission

ELECTRONIC CLAIMS SUBMISSION

AAMG Payer ID: AAMG1

For questions or assistance regarding electronic claim submission, please contact our claims department at (415) 216-0088.

PROVIDER DISPUTES

A provider dispute is a written notice from a provider that challenges, appeals, or requests consideration in any of the following categories:

  • Claim

  • Billing Determination

  • Appeal of Medical Necessity

  • Utilization Management Decision

  • Request for Reimbursement of Overpayment

  • Contract Dispute

  • Other Categories Not Listed

HOW TO SUBMIT PROVIDER DISPUTES
Providers are required to complete the necessary PDR forms:

Disputes must include:

  • Provider's Name or ID Number

  • Contact information, including phone number

  • The number assigned to the original claim (on the EOB)

DISPUTE SUBMISSION

Dispute submissions must be sent via fax to (626) 943-6369 or via mail to Network Medical Management Claims Research and Resolution, 1600 Corporate Center Dr., Suite 106, Monterey Park, CA 91754.

Unless required by any state or federal law or regulation, provider disputes must be received within 365 days of the denial or payment determination, or, in the case of inaction, within 365 days of the time for contesting or denying claims.