The Prime Health networks are more than just "dots on the map"
and deep discounts. While we do have providers located all across
the nation with competitive discounts, our focus is in developing
provider networks that meet the specific needs of our individual
clients. This is done through customization and effective
contracting in which there is no confusion on the part of the
provider as to which of the market segments they are contractually
agreeing to provide discounted services.
Workers Compensation -
Our workers compensation network of over 700,000 providers is
customized to include providers who have demonstrated a historical
understanding of the unique requirements involved in treating
workers compensation injuries, and/or are receiving a large
percentage of our clients' medical payments.
Health - Prime Health's Group Health PPO
provides our clients access to over 700,000 physicians, ancillary
services and hospitals nationwide. We are committed to the
continuing growth of this network to further meet the needs of our
group health clients.
Auto PPO - Prime
Health's Auto PPO has over 450,000 physicians, ancillary services
and hospitals with providers in all 50 states and the District of
Columbia, providing first-party Auto PPO care and aggressive
savings for our clients.
Technology - Industry
leading real-time bill repricing through our industry-standard
re-pricing and reporting platforms.
Credentialing - All
provider contracting, credentialing and re-credentialing are done
in-house. This is not "subbed out" to a third party, delivering a
level of quality not rivaled by any of our competitors.
Customization - We run
DAILY client reports that identify out-of-network providers on the
last day's claim run. This list is sorted by "dollar amount" and
"frequency of claim", and is then delivered to our team of
professional contracting specialists to be worked. The provider is
contacted for contracting into the network. NO other network has
committed the resources or shown the same level of expertise when
it comes to network customization.
QueBall Nomination Management
System - QueBall gives our clients online access to
our provider nomination tool. Through QueBall, our clients can
submit their nomination online. Our network development team will
then work to recruit the provider into the Prime Health network on
behalf of our client.
Retention - Provider disputes average less than 1%
nationally and provider retention is over 99% in large part because
of our contracting methodology and our commitment to resolving
nearly all provider issues in one business day.