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Providers

Benefits of Joining the Prime PPO Network

Not all PPO networks are the same. Increase your access to patients and improve the payment process. We strive to have a mutually beneficial relationship with our in-network medical providers, optimally saving you time and money on the administrative side of your business. 

Technology

Industry leading real-time bill re-pricing. We save you both time and money. Although our clients are under contract to pay clean claims within 30 days, claims are processed and paid within an average of 14 days because of the advanced EDI platform we built. We have a stake in ensuring Prime Providers benefit from our agreement financially and are paid in a timely manner; we are not paid until our providers are paid.

Credentialing

All provider contracting, credentialing, and re-credentialing is handled in-house, delivering a level of unrivaled quality. Delegated credentialing is available if your organization already credentials your providers in adherence to a recognized standard such as URAC, NCQA, JCAHO, etc., saving you time in the often-tedious process of credentialing.

Customization

We have the capability to track the progress of our contracts, comparing previous versus current patient quantity to show periodically the patient increase, client origin, and the additional revenue resulting from their affiliation with our network.

Referral Management System

Clients have online access to our provider nomination tool, QueBall, which allows them to submit their provider nominations at the click of a button. The marketing we perform on behalf of our providers is pinpointed to the clients, case managers, patients, etc. that will actually be seeing you. Our website, social media pages, the provider directory, newsletter, and conferences are examples of how we continuously promote our network of providers to our client community.

Provider Disputes | Provider Relations

Provider disputes average less than 1% nationally and provider retention is over 99%. In large part, this is because of our contracting methodology and commitment to resolving provider issues within one business day. We also have a Provider Relations team that is dedicated to you.

Broaden Your Patient Scope

Prime Health Services specializes in quality PPO network development, increasing the provider or facility's access to patients while improving the speed of payments.

Our preferred provider network serves insurance carriers, third-party administrators (TPA), self-insured, government, and captive insurance clients in the workers’ compensation, commercial group health, corrections (indigent care), Medicare, and auto liability markets. We have a vast client list spread across many industries.

Being a privately-owned company allows us to be nimble to give our providers prompt service and personal attention. Ensuring each provider we work with knows exactly what services they are agreeing to is key to servicing our clients and their employees or members in the best way.

 

Take a look at what we offer.

Workers’ Compensation PPO

Our most prolific product is the customized network of strategically selected providers who have demonstrated a historical understanding of the unique requirements involved in treating workers’ comp injuries, and / or are receiving a large percentage of our clients’ medical payments.

Group Health PPO

We provide our clients with access to physicians, ancillary services, and hospitals nationwide. We are committed to the continual growth of this network to further meet the needs of our group health clients.

Auto PPO

Physicians, ancillary services, and hospitals providing first-party auto PPO care for our clients. Leading auto insurers are not only looking for access to a premier network contracted to handle the unique injuries of the motor vehicle injured patient, but as referral sources to make sure that follow-up care, beyond the emergency room, is accessed. 

Along with access to quality care, insurers / payers are looking for quantifiable results in an outcomes-based setting.

Looking For Something More?

Looking for a preferred provider network that is more than just dots on the map? 

Network development is our passion. Prime Health Services focuses on developing provider networks that meet the specific needs of our individual health care, insurance, and self-insured clients. This is accomplished through 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 services. Our network of providers is comprised of those hand-selected based on their quality of care and strategic location.

As a provider in the Prime Health Services Network, you will help assure that the best care is provided – yours!