Group Health

Committed to Quality

At Prime Health Services, we leverage the power of Renovo Technology Solutions to provide innovative healthcare cost containment services for the group health market. Our technology-driven platform and extensive network solutions enable insurance carriers, TPAs, and employers to customize their networks and streamline claims processing—without sacrificing speed or accuracy.

Why Choose Prime Health Services?

Technology-Driven Efficiency

Web-based tools with sub-second response times for claims validation and processing.

Custom Network Solutions

Options based on Medicare discounts, geographic carve-outs, and threshold discounts to maximize savings.

Commitment to Data Integrity

We follow URAC and NCQH credentialing standards and are a member of the Synaptic Health Alliance.

Proven Network Adequacy

With our Healthy Network Report, provider nomination system, and dedicated relations team, you always get the coverage you need.

Comprehensive National Coverage

With 850,000+ providers across all 50 states, we offer:

Logo & Non-Logo PPO Networks

Wrap & Narrow Networks

Physician-Only Networks

Custom Networks

Network & Cost Containment Solutions

Logo Full Network

Our Logo Full Network provides extensive access to a broad national provider base. Clients benefit from:
✔️ Recognizable network branding for ease of provider acceptance
✔️ Comprehensive national access to physicians, hospitals, and specialists
✔️ Pre-negotiated discounts for cost savings

Supplemental PPO

The Supplemental PPO serves as a secondary network to enhance primary network coverage by:
✔️ Filling gaps in network access for out-of-network claims
✔️ Providing additional discount opportunities beyond the primary PPO
✔️ Ensuring continuity of care by covering providers outside the standard network

Bill Review Services

Our advanced Bill Review solutions ensure claims accuracy and maximize cost savings through:
✔️ Automated claim auditing to identify billing discrepancies
✔️ UCR (Usual, Customary & Reasonable) and Medicare-based pricing reviews
✔️ Fraud, Waste & Abuse detection for additional cost containment

Technology-Driven Claims Management

✔️ Real-Time Claims Editing

Instant validation, repricing, and compliance checks

✔️ Front-End Edits

Reduces errors and claim severity before processing

✔️ Seamless Integration

Fully automates PPO network and invoicing processes

To Make Requests For Further Information,
Contact Us!

Call Us Or Email For Any inquiry

Phone: (866) 348-3887
Email: info@primehealthservices.com