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Texas Health Care Network

Texas is the 2nd largest state by population, has the largest number of counties, and has the 2nd highest workers compensation costs in the country. The costs to employers were making it difficult to operate in Texas and still be competitive. The Texas Division of Insurance created the Texas Health Care Network (HCN) in 2005 to provide a tool to employers in their effort to control the rising costs of claims. A major part of this legislation was the creation and certification of networks of providers that were focused on return to work treatment guidelines.

Please contact us for more information regarding the Prime Health Services TX HCN.

Prime Health Services becomes the largest Texas HCN

In 2010, Prime Health Services set the goal to be the largest (in terms of certified counties) of any Texas HCN. Through aggressive direct contracting with Texas-based providers, Prime Health achieved that goal early in 2012. Because our contracting effort is recent, the Prime Health Services HCN provider population has been provided with more current guidelines, communication, and compliance information.

Prime Health Services is certified in 250 of the 254 counties in Texas, and includes over 37,000 providers. (The Texas Department of Insurance has not approved the remaining 4 counties for any network.) As a result, Prime Health is better positioned than any other PPO network to cover the geographical needs of any client in the state of Texas.

Quick facts

  • 250 out of 254 counties (remaining 4 not approved for any network)
  • Majority of providers contracted below fee schedule
  • Highly customizable to meet individual client needs.
  • Over 37,000 providers and growing
  • Initial credentialing included treating provider on-site visits
  • Notification materials in English or Spanish
  • Case Management, Utilization Management, Utilization Review are available, as required, if necessary
  • Flexible pricing options

 

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Regarding the Prime Health Services TX HCN, please see below downloadable copies of the necessary forms referenced in our Employer Packet: