What is a PPO?
A PPO, Preferred Provider Organization, is a group of physicians, clinics, medical practices and
hospitals who have agreed to discount their charges for individuals insured under their specified
insurance plans. The medical providers who join into a Preferred Provider Organization have done
so because the health care environment is competitive and they want to provide service to good
customers like you.
About the PPO Networks
The PPO Networks ACI partners with are National Provider Networks, which provides you comfort in
being able to locate a medical provider in the PPO Network when you are away from home in the U.S.
These PPO Networks are nationally well-known Networks and are highly competitive with the discounts
obtained for services rendered by the participating providers.
What a PPO means to You
If your plan pays benefits at different rates for In-Network and Out-of-Network charges, this is
called a Captive PPO and you have come to the right place on the ACI website. Finding an
In-Network Medical Provider is critical in avoiding unwanted and unnecessary large balance due
bills from providers. Selecting a participating PPO provider will ensure you are maximizing the
benefits of your insurance plan because if your claim is payable, you will receive the highest
coinsurance benefit AND a lower overall balance due to the provider since the charges will be
discounted.
If your plan does not have different rates for In-Network and Out-of-Network charges you can
still take advantage of PPO discounts if you choose a physician within the PPO Network
identified on your ID Card. If no PPO Network has been identified, please choose a physician
under the Multiplan Network logo to the left.
When receiving treatment at a PPO Network provider, be sure to identify yourself as a subscriber
to the PPO Network identified on your insurance ID Card. If being referred to another physician,
request a PPO Network provider in your plan identified Network.
Discounts will be applied at the time ACI receives the claim from the provider. Medical
Providers are not permitted to balance bill you the difference between their standard charge
and their discounted charge. However, there may be minimal balances due the provider due to
co-pays and deductibles contained in your policy. Please review your plan for the benefit
structure of your policy.
ACI Web Site Privacy Statement
ACI strongly believes in maintaining the privacy of nonpublic personal information we collect from
individuals who visit our web sites. We want you to understand how and why we collect, use and disclose
the personal information about you on our web sites. ACI’s practices and procedures are in compliance
with privacy laws and/or regulations such as the federal Gramm-Leach-Bliley Act (GLBA). All information
collected from our web site and our companies in general that is subject to the applicable privacy laws
and regulations will be handled according to our ACI Privacy Statement. This Web Site Privacy Statement
supplements the ACI Privacy Statement by providing you with information concerning ACI’s practices and
procedures as they relate specifically to information we collect at this web site.
PERSONAL INFORMATION WE COLLECT AND USE AT THIS WEB SITE
We do not collect any personal information about you at our web sites unless you choose to provide it
to us voluntarily. We define “personal information” as information that is unique to you and might
include your phone number, name, age, address or Social Security number. If you encounter a screen or
page that requests information you do not want to share with us, do not enter the information and do
not proceed with that screen or page.
If you do provide us with personal information, we will only use it for the purposes described where
it is collected, and we will not sell, license, transmit or disclose this information outside of ACI
unless (1) you expressly authorize us to do so, (2) it is necessary to allow our contractors or agents
to provide services for us, (3) in order to provide our products or services to you, (4) it is
disclosed to entities that perform marketing services on our behalf or to other entities with whom we
have joint marketing agreements, or (5) otherwise as we are required or permitted by law.
EMAIL
We appreciate your questions and comments about our web site and services and welcome your email
messages to mailboxes listed on our web sites. We will share your messages with those within our
organization who are most capable of addressing the issues contained in your message. We will keep
a copy of your message until we have had an opportunity to address your concerns. We may archive
your message for a certain period of time or discard it, but your email address will not be used
for any other purpose.
CONFIDENTIALITY AND SECURITY
We restrict access to personal information collected about you at our websites to our employees,
our affiliates' employees, or others who need to know that information to provide services to
you or in the course of conducting our normal business operations. We maintain appropriate
physical, electronic, and procedural safeguards to protect personal information.
THE RIGHT TO VERIFY THE ACCURACY OF INFORMATION WE COLLECT
Keeping information accurate and up to date is important to us. An individual may see and correct
their personal information that we collect except for information relating to a claim or a criminal
or civil proceeding. Contact us at the address provided below if you wish to verify your
personal information.
LINKS TO OTHER SITES
For your convenience we may provide links to other web sites and web pages that we do not control.
We cannot be responsible for the privacy practices of any web sites or pages not under our control
and we do not endorse any of these web sites or pages, the services or products described or
offered on such sites or pages, or any of the content contained on those sites or pages.
USE OF “COOKIES” OR OTHER DATA COLLECTION TOOLS
A cookie is a piece of information which a web server may place on your computer when you visit a
web site. Cookies are commonly used by web sites to improve the user experience and have not been
known to transmit computer viruses or otherwise harm your computer. Many cookies last only through
a single web site session, or visit. Others may have an expiration date, or may remain on your
computer until you delete them.
We may use cookies for a number of purposes - for example, to maintain continuity during a user
session, to gather data about the usage of our web site for research and other purposes, to
store your preferences for certain kinds of information and marketing offers, or to store a
user name or encrypted identification number so that you do not have to provide this
information every time you return to our web site.
Our cookies will track only your activity relating to your online activity on this web site,
and will not track your other Internet activity. Our cookies do not gather personally
identifiable information.
You can decide if and how your computer will accept a cookie by configuring your preferences
or options in your browser. However, if you choose to reject cookies, you may not be able to
use certain of our online Products and Services or Web Site features.
We may occasionally use other companies to set cookies on our web sites and gather cookie
information for us. In some cases we may also use another company to operate web servers
for our web site. We use the cookie information gathered by these companies in the same
manner as stated above.
In addition to the information we collect from cookies, we also obtain information which
you provide to us online - for example, when you use our tools and calculators or when you
submit an application or otherwise communicate with us. In some cases, we retain both the
cookie information and/or the information you provide to us online - for example, to
complete a transaction you requested or to keep historical records of your past transactions.
In other cases - for example, when you use our tools and calculators - we only retain the
cookie and/or online information you give us if you request us to do so for your use in
subsequent sessions.
CHANGES TO OUR WEB SITE PRIVACY STATEMENT
We may change this Statement at any time and from time to time. The most recent version of
the Statement is reflected by the version date located at the bottom of this Statement.
This Statement is not intended to and does not create any contractual or other legal
right in or on behalf of any party.
ACI GENERAL PRIVACY STATEMENT
Below is the ACI Privacy Statement in accordance with privacy laws and/or regulations
such as Title V of the federal Gramm-Leach-Bliley Act that is sent to all customers who
purchase an insurance product that is used primarily for personal, family or household
purposes.
ACI PRIVACY STATEMENT
ACI strongly believes in maintaining the privacy of information we collect about
individuals. We want you to understand how and why we use and disclose the collected
information. The following provides details of our practices and procedures for
protecting the security of nonpublic personal information that we have collected
about individuals.
INFORMATION WE COLLECT
The information we collect will vary depending on the type of product or service
individuals seek or purchase, and may include:
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Information we receive from individuals, such as their name, address, age, phone
number, social security number, assets, income, or beneficiaries;
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Information about individuals’ transactions with us, with our affiliates, or with
others, such as policy coverage, premium, payment history, motor vehicle records; and
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Information we receive from a consumer reporting agency, such as a credit history.
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INFORMATION WE DISCLOSE
We do not disclose any personal information to anyone except as is necessary in order to provide
our products or services to a person, or otherwise as we are required or permitted by law.
We may disclose any of the information that we collect to companies that perform marketing
services on our behalf or to other financial institutions with whom we have joint marketing
agreements.
THE RIGHT TO VERIFY THE ACCURACY OF INFORMATION WE COLLECT
Keeping information accurate and up to date is important to us. Individuals may see and correct
their personal information that we collect except for information relating to a claim or a
criminal or civil proceeding.
CONFIDENTIALITY AND SECURITY
We restrict access to personal information to our employees, our affiliates' employees, or
others who need to know that information to service the account or in the course of
conducting our normal business operations. We maintain physical, electronic, and procedural
safeguards to protect personal information.
Last Updated: April, 2013
Claim Appeal Procedure
At ACI, we want to ensure your claim is processed according to the terms of the policy you purchased.
If you, the member or the provider of service received a denial of your claim and you would like your
claim reviewed or have questions regarding the reason for the denial, please contact our Customer
Service Team at 888-293-9229 or direct an email to
claims@visit-aci.com.
Our Customer Service Team will review the claim with you and provide responses to any questions you may have at that time.
If for any reason we are unable to assist you over the phone, please feel free to file a written
appeal to our office, to which ACI will respond formally in writing. If submitting a written
appeal, please provide the following information:
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Any additional documentation which may support your claim
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Insured Name (if a dependent, the Dependent Name also)
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Insured Current Contact Information: Address, Phone Number, E-mail
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Group Name
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Policy Number
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Your appeal will be reviewed by an individual other than the Claims Examiner who processed the claim
and a decision in regards to the appeal will be provided to you within 30 days. If there are any
delays in responding to your appeal, ACI will notify you of the progress of the review and inform
you when you may anticipate a decision to your appeal.
ACI
P.O. Box 4000
Collegeville, PA 19426-9000
Fax: 610-293-9299