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Specialty Networks

More Than A PPO Network

Prime Health Services offers specialty networks that allow a client tailored access to specific health care needs, such as surgery, hearing, independent medical reviews, and more.

PRIMEsurgical

PRIMEsurgical, powered by PriceMDs, is the nation’s largest provider offering of managed surgical care with:

  • over 1,400 Ambulatory Surgical Centers
  • 14,000+ quality surgeons offering services
  • over 400 outpatient surgical procedures
  • discounted & bundled rates

PRIMEsurgical offers a comprehensive price discovery platform to claim handlers before a procedure is scheduled with the “all in” final fee.

PRIMEsurgical 'All-In' bundled pricing.

  • Surgeon’s preliminary visit
  • Surgeon’s post procedure visit
  • Surgery
  • Facility charges
  • Anesthesiologist
  • Pathologist
  • Hardware, implants (DME)
  • Imaging & pharmacy fees

A key component is all-inclusive bundled pricing in the aggregate with no hidden fees or details of various components involved with each surgical procedure.

PRIMEsurgical specializes in over 28 commonly performed muscular skeletal surgeries.

The process is simple, call 855-747-7874 to speak with a PRIMEsurgical Advocate to locate a surgeon/facility.

PRIMEhearing

What if you could save on protecting your workers’ hearing?

Workers' compensation claimants in various industries suffer hearing injuries. And hearing loss presents lasting problems for the claimant.  To this end, Prime Health Services has developed the Prime Hearing program.

Partnering with American Hearing Benefits (a division of Starkey Hearing Technologies - the only remaining American owned and operated, major hearing aid manufacturer), our program offers access to quality audiologists and hearing aid dispensers.

Join us, and save big on hearing.

Clients accessing the Prime Health Services PPO (PrimePPO) Network will receive significant savings on hearing solutions. Additionally, our program offers…

  • Audiological Review Process ensures accurate eligibility and product placement details.
  • Program is easily accessible to clients utilizing Prime Health Services PPO Network.
  • A nationwide network of Audiologists and Hearing Aid Dispensers with over 3,000+ credentialed provider locations.
  • As a Prime Health Services client you receive cost reduction and containments strategies saving you thousands of dollars per hearing loss claim.
  • Access to the Prime Hearing affinity program for all employees.

Finally, Prime Hearing offers ease of access. A hearing injured patient or person needing hearing aid services will be directed to an in-network provider who will do audiology, fitting, and supply the product all in one place.

If you're a current Prime Health Services client, Case Managers and Adjustors need only to call our intake number 1.877.760.3830 to get started today! 

PRIMEime

As a Prime Health Services' client, we offer many medical management tools for your convenience such as Independent Medical Evaluations (IME), functional capacity evaluations, and peer reviews through our key partner MLS Group of Companies, LLC.

MLS is recognized for their experience and commitment to providing exceptional client service, objective medical assessments, and the protections associated with cutting edge information technology.

MLS's workflow process and procedures revolve around safeguarding confidential information to maintain the highest security standards, and to maintain the integrity of claim-related data within the virtual cloud network.

Additional medical management services offered.

The goal of these additional services is to provide our clients with an unbiased assessment to assist with adjudication requirements and challenges, as well as provide cost effective solutions to claims management.

Independent Medical Evaluations (IME) - An objective, third party medical exam of an individual to establish; causation, treatment appropriateness, return to work, restrictions, impairment ratings, and maximum medical improvement.

Peer Reviews - An evidence based review conducted by actively practicing physicians versed in the latest medical research and current guidelines to establish an informed opinion about the appropriateness of care, medical necessity, experimental/investigational, and related issues.

FMLA Assessments - An objective assessment to establish if the employee meets the criteria of a serious health condition, from the clarification level up to a third opinion.

Impairment Ratings - Prospective/concurrent analysis of impairment ratings by trained physicians to determine the accuracy, based on the AMA Guidelines.

Utilizing Prime Health Services' PPO network of directly contracted medical providers, in addition to having access to MLS Group of Companies accredited national network of physicians and allied medical professionals gives a client access to service across the entire United States. All major specialties and subspecialties are available, with expertise in a wide variety of areas ensuring that clients have access to the most thoroughly vetted, credentialed, and trained professionals. We look forward to providing accurate, objective, and comprehensive reviews utilizing innovative technology and swift turnaround times.

To request services or for further information, please call 888-657-4634 toll-free.