Provider FAQ

What is NAMCI?
North Alabama Managed Care, Inc., (NAMCI) is a Preferred Provider Organization (PPO) founded in 1991 that contracts with physicians, hospitals and other medical providers to provide quality medical services at preferred rates.

Is NAMCI an insurance company?
NAMCI is not an insurance company or a claims payor. NAMCI does not maintain client-specific benefit, eligibility and claims payment information. Please refer to the patient's health identification card to determine the appropriate agency/organization and telephone number for the following items:
• Patient Verification of Eligibility
• Determination of Benefits
• Pre-Authorizations (Pre-Certification)
• Utilization Review
• Emergency Admissions
• Claims Submission Instructions
• Claims Status Inquiries

NAMCI representatives are available Monday through Friday, 8:00 AM to 5:00 PM to answer questions and provide assistance at (800) 636-2624 or (256) 532-2755. The NAMCI fax number is (256) 532-2756.

What is Premier Health Plans and how is it connected to NAMCI?
Premier Health Plans of Alabama is a well-established trade name for NAMCI. Premier is not a separate provider network or an insurance company. Some employer groups utilize the PPO network under the name 'Premier Health Plans' or 'NAMCI/Premier'. The 'NAMCI' and 'Premier' names are synonymous and should be treated accordingly.

What type of providers are included in the network?
NAMCI's select network of contracted health care providers includes primary care physicians, specialty physicians and hospitals as well as a wide range of ancillary providers. These include radiology facilities, chiropractors, optometrists, physical therapists, podiatrists, home health care agencies, durable medical equipment providers, mental health counselors, chemical dependency recovery facilities, psychiatric hospitals and kidney dialysis centers.

What are the advantages of being a NAMCI provider?
• Large patient volume
• Established relationships with multiple payors
• Competitive reimbursement
• Dedicated provider servicing department

How can I apply to join the NAMCI network?
Contact our Provider Relations Department during normal business hours 8:00am - 5:00pm (Central Time) at (800) 636-2624 and request an Application to Participate.

How long does it take to become a NAMCI provider?
The credentialing process must be completed before new providers can be added to the network. This process takes approximately 45 days.

For physicians, our selection criterion covers education and training, licensure, board certification, malpractice history and liability insurance coverage. Applications are reviewed with regard to quality indicators including specialty board certification, level of hospital privileges, malpractice record, and sanctions by government agencies, hospitals and professional organizations. Hospitals and Ancillary providers are chosen based on criteria to evaluate their quality of care.

How do I contact NAMCI if I have a question?
You may contact NAMCI at (800) 636-2624 during normal business hours, 8 a.m. to 5 p.m. (Central Time).