The American Health Group system has been serving clients for over 25 years. As a proven leader in medcal management services, our team of professionals provide solutions to employers, members, TPA’s (third-party administrators), PBM’s (Professional Benefit Managers), Reinsurer’s and others. The services available in our system include:
American Health Group, Inc.
2152 S. Vineyard, Suite 103
Mesa, AZ 85210
Freephone: (800) 847 7605
Telephone: (602) 265 3800
FAX:           (480) 894 8105
E-mail: info@amhealthgroup.com
Our high-tech, high-touch approach coupled with our experience will produce the results you want ... The right amount of care, at the right time, and the right place!

Our team of highly skilled nurse case managers are talented health coaches with experience in diabetes and cardiovascular disease, oncology, behavioral health, transplants, occupational health, health promotion, and disability prevention. The result of our experience will provide you with:
A complete understanding of the needs of the patient
Knowledge of health care risks through our risk identification tools
Telephonic health coaching skills
Physician and health care team engagement
Exceptional patient quality and service excellance
Channel services to in-network providers and free community resources
Costs savings for the patient and group
To make a referral, call 602-265-3800 or 800-847-7605 and ask for case management.
At no charge, AHG will review the potential for recovered overpayments in a hospital, surgi-center, or surgery bill and inform you if the prospective savings are worth negotiating or should just be paid. The negotiation is done in a couteous and tactful manner. You are not charged for our services until the facility agrees to a refund. If the negotiation does not succeed the bill analysis is forwarded to you, the payor, at no charge. AHG hospital audits produce evidence-based results that are supported with clinical documentation and cost records from the audited facilities. With the findings from our audit, the health care plan is in a very strong position to reduce payments as a percent of charges, and in turn reduce the incidence of overpayment at the audited hospital in the future.
Navigating your way through the health care system maze can be frustrating to say the least. Our health advocacy staff is prepared to save you time and frustration. Take some time and let us guide you through the health care proces 24/7!
Navigate the health care system
  • - understand your benefits and minimize your costs
  • - locate the best provider that is in your network
  • - secure a second opinion

  • Health education
  • - Understand your diagnosis, results of testing, and treatment options
  • - Better prepare for physician visits
  • - Identify cost-savings on prescription drugs

  • Advocacy services
  • - Understand your explanation of benefits
  • - Assist with the claims appeal process
  • - Coordination of services
  • For any procedure requiring precertification (or prior authorization) we will need the provider (doctor or hospital) to fax all the supporting medical documentation to AHG. Once the records are received, they are reviewed to determine whether the procedure is a covered benefit and the requested service meets established medical guidelines. If the review supports certification, then an authorization code is given to the provider confirming the procedure go-ahead. If the review determines the procedure is not medically necessary, a denial letter is mailed. A denial can be appealed. If the records are never received, a letter of Non-Compliance is mailed to the provider.

    Treatments requiring precertification are:
    Elective Admission to Hospital (inpatient or outpatient)
    Maternity Admission (1st trimester)
    Psychiatric Admission(s)
    Chemical Dependency/Rehab Facility Admission(s)
    Skilled Nursing Facility Admission(s)
    Infusion Therapy Treatment
    Diagnostic Procedures Exceeding $1000 (MRI, CT, Pet scans, etc.)
    Home Health Care Plans
    Durable Medical Equipment
    Hospice Care
    Our utilization management program provides our customers with integrated services that are coordinated across all service lines. We strive to prevent over-utilization of healthcare services by maximizing the quality of healthcare delivery and avoiding unnecessary healthcare costs. The program is designed to positively impact claims costs and provide savings to benefit plans and their members. Team members have access to a board certified Medical Director and an external panel of medical specialists.
    Some of the most important issues affecting employees are stress, personal and family issues, and chronic medical conditions. Life-style changes can improve health and reduce controllable health care costs. Our comprehensive program is targeted to improve health and wellness, assisting participants in becoming an accountable partner, and enhancing workforce health which will positively impact both the employee and company.
    Driven by company wellness teams
    On-line Personal Wellness Profile with optional biometrics
    Receive telephonic health coaching for by nurse health coaches and jointly establish a Personal Wellness Guide to incorporate into your daily life
    Web-based lifestyle intervention program
    Annual aggregate reporting on participation and overall member health
    Prematurity is a serious health problem. Each year in the United States, more than 50,000 babies are born prematurely.

    Our aim is to focus on the early identification of high risk pregnancies and provide careful monitoring of the progress of the pregnancy to ensure full-term deliveries and healthy infants. Our highly trained nurse case managers ensure that each mom receives:
    Early screening for identification of maternal and fetal risk factors
    Counseling and health education during the pre- natal, delivery, postpartum periods and for the needs of the newborn
    Options and solutions for moms who face the challenge of a high-risk pregnancy
    Referrals to community organizations for education and support
    Support for mom following delivery
    Our utilization management program provides our customers with integrated services that are coordinated across all service lines. We strive to prevent over-utilization of healthcare services by maximizing the quality of healthcare delivery and avoiding unnecessary healthcare costs. The program is designed to positively impact claims costs and provide savings to benefit plans and their members. Team members have access to a board certified Medical Director and an external panel of medical specialists.