Information and Resources for Employees and Covered Family Members
We give you and your family access to higher-quality care at a fair and affordable price. Our vast networks include more than 38,000 doctors and healthcare providers across the Midwest, meaning you’ll have plenty of options when it comes to choosing care — and since more providers are in-network, you’ll have protection against out-of-network surprise bills.
Nobody else approaches benefit and network design with our level of passion and commitment; your priorities are our priorities. We’re your voice and advocate in securing high-value healthcare for you and your loved ones.
Avoiding Facility Fees
How We Help You Avoid Unexpected Fees
Did you know that where you see your doctor can impact the fees you pay for your visit?
What is a facility fee?
A facility fee is an additional charge you may have to pay if you see a doctor at a clinic they don’t own themselves. Facility fees are common at hospital-owned clinics to cover maintenance costs. They can range from $20 to hundreds of dollars depending on the services you receive and are charged on top of the fee for seeing the doctor.
Are facility fees covered by my insurance?
Many insurance plans do not cover facility fees — or only cover a portion. Additionally, facility fees may not count toward your deductible. To better understand facility fees and what your plan covers, talk to your benefits administrator (your TPA). Their number can be found on the back of your health insurance ID card.
What can I do to avoid facility fees?
To find out if you will be charged a facility fee for a service, you should call the provider before your appointment and ask if they charge facility fees.
Use our Find a Doctor tool to search for in-network doctors, hospitals, and specialists, and find cost and quality information for certain procedures.Find a Doctor
We’re empowering patients to make smarter, more informed health decisions. Our Smarter Care AdvisorSM helps you search for procedures and filter by provider network and location. We’ll even give you a cost estimate! Compare your healthcare options today.
Frequently Asked Questions
Who is The Alliance? How do they work with my employer?
The Alliance negotiates reduced rates from healthcare professionals and facilities on behalf of our employer-members and their employees.
- All providers we negotiate discounts with are added to The Alliance networks, which you have access to as an employee of an employer-member.
- We are not an insurance company — instead, think of us as a link between your doctor’s office and you.
- We make sure you are charged the lowest negotiated rate.
The Alliance is based in Fitchburg, Wisconsin, but services other parts of the Midwest, including Illinois, Iowa, Minnesota, and Michigan. As a not-for-profit cooperative of employers who are committed to helping their employees make the best healthcare choices, The Alliance helps your employer provide you with access to healthcare providers at a reasonable cost.
Is my employer part of The Alliance?
You can find out by looking for one of The Alliance logos on your health ID card.
How can I find a doctor or hospital that participates in The Alliance networks?
Use our Find a Doctor tool. This resource lets you take charge of your search for doctors, hospitals, clinics, and procedures. The search tool features simple navigation and a mobile-friendly design for easy access, whether you are on your smartphone, tablet, or computer.
Explore your options by looking up procedures, specialties, facility types, and physicians. Enhance your search by sorting search results by name, distance, gender, or languages spoken. If you have questions, contact The Alliance customer service advocates by calling 800.223.4139 (select Option 3).
Who do I contact about my benefits, including what's covered and what I'm responsible for?
To find out what is covered, check the health plan information you received from your employer. If you don’t have that, speak to your human resources representative or contact your Third-Party Administrator (TPA). A TPA is hired by and works with your employer to process your claims.
Your TPA’s number can be found on the back of your health insurance ID card.
I am outside of The Alliance service area, how do I find participating providers?
Many of The Alliance’s employer-members offer an additional network that provides plan members access to providers while traveling outside of The Alliance’s service area. Please check your ID card to determine if an additional network logo and phone number are listed and contact them directly for more information.
If you cannot find any reference to additional networks on your ID card, please contact your Third-Party Administrator (TPA) directly for further assistance. Your TPA’s number can be found on the back of your health insurance ID card.
Who do I contact to get approval or pre-certification for surgery or another procedure?
Your Third-Party Administrator (TPA) has access to your benefit plan, including what type of services are covered and what you’re responsible for. For questions about pre-certification, call the number on your health ID card or your TPA.
What are my deductible, co-pay, and coinsurance responsibilities?
To learn more about your group health plan’s deductible, co-pay, and coinsurance levels, check the health plan information you received from your employer. If you don’t have that, speak to your human resources representative or contact your Third-Party Administrator (TPA). Your TPA’s number can be found on the back of your health insurance ID card.
Can you tell me how much of my deductible and coinsurance liability has been satisfied?
Your Third-Party Administrator (TPA) is responsible for applying and tracking how much of your deductible and coinsurance obligation has been satisfied. Please contact them directly for this information. Your TPA’s number can be found on the back of your health insurance ID card.
Who do I contact to find out about dental or prescription drug claims?
Your employer does not work with The Alliance to provide dental or prescription drug coverage. To answer these questions, you will need to speak to a representative from one of these plans.
If you’re not sure who administers your dental or prescription benefit, please speak with your human resources representative.
I need a new ID card, who should I contact?
ID cards are issued by your Third-Party Administrator (TPA). Please contact them directly or speak with your human resources representative for further assistance.
Who do I call if my claim was denied or if I’m not sure if a claim was paid?
Your Third-Party Administrator (TPA) has access to your benefit plan, including what type of services are covered and what you’re responsible for. Your TPA’s number can be found on the back of your health insurance ID card.
How can I make sure my claims are paid correctly?
Make sure you always show your health plan ID card when you visit the doctor or another healthcare professional. That way, they will know how to process your bill. They’ll send your bill to The Alliance first to ensure you receive the lowest cost available to you.
I have received a bill from my healthcare provider for The Alliance discount referenced on my Explanation of Benefits (EOB). What should I do?
Contact The Alliance Customer Service by calling 800.223.4139 (select Option 3).
What happens between when I visit a doctor and when I get my bill?
Going to the doctor sometimes seems like the easiest part of the equation. Find out what happens between the time you visit the doctor and the time you pay your bill.
- You visit the doctor.
- The doctor creates and sends a claim to The Alliance.
- We apply the agreed-upon rate to the claim for any services you received. In healthcare terms, we reprice the claim.
- Next, we forward it to your Third-Party Administrator (TPA). This all happens within less than 3 days from the day we receive your claim.
- Your TPA reviews the claim and your healthcare coverage and pays any amount due to the provider under your plan, except for coinsurance and deductibles.
- Your TPA sends you an Explanation of Benefits (EOB).
- The doctor sends you a bill for the difference, if any, between the payment received from the TPA and what you owe based on your benefit plan, such as a co-pay or deductible.
Want to learn more about The Alliance?
We serve as a relentless advocate for you, your family, and your employer in securing the best care at the lowest cost. By directly negotiating lower prices on your employer’s behalf, we incentivize providers to deliver higher-quality care at a more affordable price. And with easy access to our vast network of doctors and facilities, you have more options when it comes to choosing a healthcare provider.
Where can I find a dictionary of key insurance terms?
The Alliance has prepared a handy page that defines key terms related to health benefits.
Contact Us Today
The Alliance® Customer Service Team
Hours: Monday-Thursday: 7:30am-4:30pm CST
Friday: 7:30am-11:30am CST