Clients
Prime separates from our competitors offering the client the best solutions for challenging needs.
We're Established
Prime Health offers experience and an entire suite of additional services to our customers.
We're Different
Unlike other PPO networks, Prime Health Services is not part of a corporate behemoth.
We're Dedicated
We know a lot of factors play into choosing the right network. We'll work with you.
What if networks could be more customized?
We’re Established
Founded in 2001, Prime Health Services has grown into a leading healthcare technology and solutions provider, transforming how organizations manage pricing, processing, and performance. With over 20 years of experience, we’ve built a vast national delivery system encompassing 700,000 providers and facilities across all 50 states and the District of Columbia.
Our latest innovation, Renovo Technology Solutions, serves as a comprehensive, customizable platform designed to streamline healthcare operations. Renovo empowers businesses with cutting-edge features like API integration, real-time network savings, automated workflows, and advanced bill processing. These tools drive efficiency, reduce costs, and improve performance for clients in industries such as workers’ compensation, group health, corrections, and liability.
Additionally, we provide advanced solutions such as Prime Metrics, PrimeRX—a proprietary pharmacy management platform—and Prime IME Solutions, delivering nationwide Independent Medical Examinations.
We’re Different
We are not a legacy PPO network. Prime Health Services is a dynamic healthcare technology company focused on delivering innovative, data-driven solutions. Our independence allows us to remain agile, giving us the flexibility to develop and implement tailored strategies that maximize savings and improve outcomes for our clients.
We’re Dedicated
We understand that selecting the right healthcare technology solutions is critical to achieving your business goals. At Prime Health Services, we work hand-in-hand with you to deliver technology-driven tools like Renovo, custom-tailored workflows, and end-to-end solutions that address your unique needs. Our mission is to enhance your operational efficiency, cost containment, and overall success.
Notices and Updates
State Compliance
Prime Health works hard to remain in compliance with the various requirements of our governments and court systems.
Prime Health Services maintains a Compliance Department to ensure that Prime Health and Prime Health’s clients remain in compliance with each state’s ever-changing laws, rules, regulations, and court decisions. Our continuous evaluation of the regulations that govern state certifications/filings allows our company and clients to offer the most up-to-date and progressive services and products to our customers.
Take a Tour of the Markets We Serve
Workers' Compensation
Group
Health
Auto
Liability
Personal
Injury
Inmate
Medical
Medicare Advantage
Claim Disputes
We have a dedicated repricing and reconsideration department with providers & partner networks diligently working to resolve claim disputes.
The goal at Prime Health is to have all clean claims with no disputes and no reimbursement issues. However, part of the nature of a PPO network is addressing, an industry average of 3% claim disputes. Prime Health is proud to have an average of 1.2% claim disputes. Clients may submit disputes via email claimdisputes@primehealthservices.com, or via fax to 615-329-4411. Clients with questions may also call our Claims Resolution Department at 1-866-348-3887.
Prime Health is dedicated to the fast response of disputed claims which applied a Prime Health discount. Our average turnaround for dispute resolution is 3 to 5 business days. Upon resolution of the claim dispute, clients will be advised in writing an explanation of the resolution and instructions if further reconsideration is necessary.
Common Reasons for a claim dispute to arise
- The EOB/EOR (Explanation of Benefits / Review), does not properly list Prime Health or our Partner Network
- Provider does not recognize their contract with Prime Health or our Partner Network
- An error in repricing the claim occurs with Prime Health or Client
Prime Health request that the following information be included when submitting a dispute:
- Provider name / or patient name in the subject line
- A copy of the EOB/EOR and corresponding claim from being disputed
- Provide a brief explanation of the dispute, or the actual appeal letter
- Provide contact name and number of the person disputing
To Make Requests For
Further Information,
Contact Us!
Call Us Or Email For Any inquiry
Phone: (866) 348-3887
Email: info@primehealthservices.com
