Provider Application

To receive a participation packet and application choose from these options:

• Complete the form at the bottom of this page with all information requested and click submit. A representative of AHG's Managed Care Department will follow upwith you within two business days.
  
• Click here to obtain a printable copy of this page and return the completed form to us by either mail or fax.
  Mail to:
  American Health Group
  Attn. Managed Care Department
  P.O. Box 1500
  Maumee, OH 43537
  Fax to: 419.891.1280
  
• If you have any questions, please call our Customer Service Department at 419.891.1212 or Contact AHG by email.

	Nominate a Provider

• If you are an employee and your doctor is not a member of one of American Health Group's networks, you can nominate your doctor to join us.
• Determine if the provider or other medical professional already participates in AHG's Managed Care Network of approved providers. Click here to complete a search.
• If the doctor is not in AHG's Managed Care Network, Click here to obtain a provider form. Print a copy of this form and take it to your doctor to complete. Once your doctor has completed the form, he may mail or fax the form to AHG.
• AHG will follow up with your doctor to discuss joining our network and gather any additional information we need.