NCQA accredits and certifies a wide range of health care organizations. All rights reserved. Networks are becoming narrower and more value-based, but consumers and regulators continue to demand access to in-network providers wherever and whenever care is sought. hb`````f``g@@,)B 5W353``>zEpC!+Y7H0+6+=;&R\$,b$/#aq It provides health plan members with seamless access to healthcare services whether they seek care in their backyard or across the country. For more information or assistance specific to our portal, please call MultiPlan Customer Service at 1-877-460-0352. Please note that including your middle initial will help us find your information faster. A full breakdown of points can be seen To find a participating provider, Click Here to return to the CommunityCare Life & Health PPO page and select the appropriate provider directory network. Using in-network providers allows Planstin to keep rates low and direct our members to high-quality health and dental care. Click on "PHCS". we make it easier for you to quickly identify the most informative profiles on Doctor.com. Private and Employer Sponsored Health Plans Medicaid Medicare Advantage Workers' Compensation Auto Medical Our network brands Nationwide and Regional Primary PPO Networks Is there someone we can contact regarding this referral? Enter the information for your search, then click continue to access the search results. This network offers access in all states and includes more than 700,000 . MultiPlan will use the money from the IPO to pay back some of its existing debt and make investments for future growth. As a group of less than 25 practitioners. 2023 MultiPlan Corporation. provider's profile, including items like having a photo, a biography, Dedicated network access for government programs. Our website uses cookies. The healthcare decision-makers at DOW Technologies were fed up with their annual healthcare cost increases. See a list of accepted insurance below, but always call to verify your specific insurance provider, as programs are updated frequently. 92 0 obj <> endobj You will be able to search by name, specialty, facility type, National Provider Identifier Number (NPI#), or license number. CommunityCare is proudly owned by two of the regions premier health systems. 2023 MultiPlan Corporation. All rights reserved. You need to enable JavaScript to run this app. MultiPlan contracts with over 1.2 million healthcare providers and facilities to add value to any healthcare payors network access strategy. Employees are happy with their benefits, deductibles are 20% lower and premiums are 20% lower." Nick Porter, Vice President, Total Rewards Signature HealthCARE PHCS logo. So they decided to take. website and services to function. 134 0 obj <>/Filter/FlateDecode/ID[<7DF81DA487C2EF44ACAA274C50B6F86F>]/Index[92 77]/Info 91 0 R/Length 173/Prev 547509/Root 93 0 R/Size 169/Type/XRef/W[1 3 1]>>stream Please contact Quartz Customer Service at (800) 362-3310 with specific code information to determine if an item or service requires prior authorization. The new Accreditation is valid through June, 21, 2022. Click Here to go to the PHCS / Multiplan Provider Search. End-Stage Renal Disease (ESRD) Premium Restoration, No Surprises Act Update: IDR Entities Will Partially Resume Issuing Payment Determinations, Certified IDR Entities Have Been Instructed to Hold All Payment Determinations Until Further Guidance Is Issued, Determining Whether a Dispute Is Eligible for IDR Is Complicating the Process. 98% of participating providers are contracted directly, >100 network development professionals across the country, Are you a healthcare payor looking for more. The following Prior Authorization List is not an all-inclusive list and will be updated on a periodic basis. MultiPlans networks are used by our clients to provide access for their members to a variety of commercial, property & casualty, and government sponsored health care programs. You need to enable JavaScript to run this app. For complete details on the scope of this review, visitwww.ncqa.org. On February 24, 2023, the Departments issued a new directive effective February 27, instructing IDREs to resume making payment determinations for disputes involving items or services furnished before October 25, 2022. hbbd```b``@$Sd7d"6`9`0 "2@WuH endstream endobj startxref All rights reserved. You need to enable JavaScript to run this app. if your ID card displays the MultiPlan or PHCS logo. The below application request link applies to participation inour Medicaid networks only. MultiPlan's PHCS Network is the only national independently-contracted primary PPO network to have been accredited by NCQA for credentialing - a status we've held continuously since 2001. 168 0 obj <>stream Visit the PHCS Network homepage. %PDF-1.6 % Total number of Providers on Doctor.com who Accept Multiplan PHCS: Most popular medical specialty of providers who accept Multiplan PHCS: Multiplan PHCS providers listed on Doctor.com have been practicing for an average of: Average ProfilePoints score for Providers who take Multiplan PHCS: Average Overall User Rating for providers who take Multiplan PHCS. Contact us Explore more resources YOUR HEALTH PLAN Complete, customized solution A self-funded health plan solution that puts members first, provides flexibility and offers savings up to 30%. To find a participating provider outside of Oklahoma, follow the steps listed below. Did you receive an inquiry about buying MultiPlan insurance? Multiplan PHCS providers listed on Doctor.com have been practicing for an average of: 30.3 year (s) Average ProfilePoints score for Providers who take Multiplan PHCS: 39/80. National primary PPO network (including our PHCS national NCQA-accredited network), Extended access for members who travel or live away, Blended access to fill gaps in a plans own network, Custom network builds for specific populations, Network contracting strategies guided by data analytics. Providers are encouraged to review the Prior Authorization List frequently for changes. MultiPlans PHCS Network is the only national independently-contracted primary PPO network to have been accredited by NCQA for credentialing a status weve held continuously since 2001. MultiPlan is committed to quality throughout the organization, and the PHCS Networks NCQA Accreditation gives our clients additional confidence that they are providing access to a quality network, said Dr. Anthony Sposato, MultiPlans Corporate Medical Director. We're currently processing your request and we'll be in touch soon. AMN/HMN/RAN Network MultiPlans regional commercial PPO networks in, HealthEOS Workers Compensation and Auto Medical Networks, ValuePoint by MultiPlan MultiPlans nationwide access (discount) network, Texas True Choice Network MultiPlans network for Medicaid programs in Texa. For more information about ASODocs and our services, insurance coverage, orthopedic doctors, office hours, or locations, please contact us online or call the Southlake office at 817-310-8783 . Saint Charles, IL 60174. Provider Directory. Box 21747 HPM50 ab PHCS network flier Rev 12/2018 Multiplan PHCS network Before scheduling your appointment or receiving services from these or any providers, check with the provider to confirm their participation in the network at . Provider Information: Please note that including your middle initial will help us find your information faster. MultiPlan is a technology-based company that uses algorithms and big data to provide healthcare cost management and data analytics for payers, providers, and customers. CommunityCare Life and Health Insurance Company provides an in-network level of benefits for services delivered outside of Oklahoma through a national PPO network, PHCS. . . Do you, or someone on your behalf, have admitting privileges to a hospital that participates in any of the MultiPlan networks (PHCS Network, MultiPlan Network or PHCS Savility)? Medicaid service areas > Texas health plan partners > Medicaid provider services & education > Information for Medicaid members This form is intended for: UnitedHealthCare Options PPO providers. To maintain its NCQA Accreditation in Credentialing, the PHCS Network underwent a rigorous review of the credentialing and recredentialing processes and demonstrated compliance with NCQAs standards. Provider Portal Provider Portal Home Inquiry Search Eligibility Claims Eligibility Fields marked with * are required. How to Access the Provider Portal The portal is secure and completely web-based with no downloads required or software to install. Read how a regional provider-owned health plan extended primary network access for its membership. July 16, 2019 (New York, NY) MultiPlan Inc. announced that in June, the PHCS Network received Accreditation in Credentialing by the National Committee for Quality Assurance (NCQA). By continuing to browse, you are agreeing to our use of cookies. MultiPlan's networks are used by our clients to provide access for their members to a variety of commercial, property & casualty, and government sponsored health care programs. icon/heading/resources Information for providers Who is Gravie? Get Directions 888-428-7890 877-428-7891. Please note: This network is available only outside of . MultiPlan's Provider Portal allows healthcare providers to verify network participation, submit billing and network inquiries, and more! 2023 MultiPlan Corporation. Claim Address: Please fill out the contact form below and we will reply as soon as possible. . The PHCS Network is available in a variety of configurations including outside the plan service area, to extend local HMO or PPO coverage nationally. <p>Please press the Continue button to proceed.</p> <input type="submit" value="Continue" /> Are you a healthcare payor looking for more information on our provider networks? And our coverage continues to grow as we identify and add quality physicians in local markets. endstream endobj 93 0 obj <>/Metadata 4 0 R/PageLabels 88 0 R/Pages 90 0 R/StructTreeRoot 11 0 R/Type/Catalog/ViewerPreferences<>>> endobj 94 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/Properties<>/XObject<>>>/Rotate 0/StructParents 1/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 95 0 obj <>stream Click Here to go to the PHCS / Multiplan Provider Search. MultiPlans team of experts helps healthcare payors manage the cost of care, improve their competitiveness and inspire positive change. NCQAs Healthcare Effectiveness Data and Information Set (HEDIS) is the most widely used performance measurement tool in health care. 2023 MultiPlan Corporation. High-quality care Significant savings that stick Deeply supportive member experiences "The results have been phenomenal. We are not an insurance company. To find a participating provider outside of Oklahoma, follow the steps listed below. Submit, track and manage customer service cases Access forms and other resources Request approval to add access to your contract (s) Search claims Download Pricing Summary PDFs Verify/update your demographic information in real time See credentialing status (for groups where Multiplan verifies credentials) MultiPlan is owned by Hellman & Friedman and other investors. The MultiPlan PHCS network is the nation's largest and most comprehensive independent PPO network. Well get back to you as soon as possible. As a group of 25 or more practitioners, such as an IPA or PHO. %%EOF To keep health and dental care costs low for our members, we highly recommend finding a provider that is in-network with us. Used standalone or in any combination, our services improve both performance and competitive advantage for our clients. When selecting a provider, contact the providers office to verify that they are still in-network with Connection Dental. You will be able to search by name, specialty, facility type, National Provider Identifier Number (NPI#), or license number. MultiPlan online application request form > Welcome Texas providers Our Texas True Choice network is your partner in delivering care to individuals participating in Medicaid and related health plans in Texas. We believe there is no such thing as a standard cost management approach. By continuing to browse, you are agreeing to our use of cookies. ProfilePoints measure the overall completeness of a LabCorp . CommunityCare Life and Health Members, please note: CommunityCare Life and Health Insurance Company utilizes the CommunityCare PPO Network within Oklahoma. HealthEOS and HealthEOS Plus Networks MultiPlans regional PPO networks in Wisconsin, with some coverage in bordering Michigan, Minnesota and Illinois. MultiPlan is owned by Hellman & Friedman and other investors. For enrollment or program information, contact the health plan administrator or government healthcare website for your state. By showing providers with higher ProfilePoints first, You need to enable JavaScript to run this app. As an ancillary facility such as a lab, rehab or hospice. When selecting a provider, contact the provider's . [Note: You may already participate in one or more of our PPO networks (PHCS, MultiPlan, HealthEOS) that serve the privately-funded health care market, but are covered by a separate agreement.] unique patients through our payor partners. We use cookies and limited processing of your personal information for our It also recognizes clinicians and practices in key areas of performance. You can also create a general, printable directory of in-network providers near you by clicking on the Create Directory button. By continuing to browse, you are agreeing to our use of cookies. We are not an insurance company. Beech Street Network MultiPlans regional PPO network in Alaska, Nevada and Utah. Click on "Change Network". Welcome to the MultiPlan Provider PortalThe portal lets you view and update your network-related information, manage tasks such as credentialing and track your customer service case history. MultiPlan uses technology-enabled provider network, negotiation, claim pricing and payment accuracy services as building blocks for medical payors to customize the healthcare cost management programs that work best for them. hXmo6PH@v[l:t"\IN{H=Yok{lRp4g,Baaa(XrMQs0_ &P@;(Lj.D+X6R@q&D%`L+vWB&"-rZd"&Lb&90y6dTn" Benefits are administered through Gravie with primary and regional leased networks through PreferredOne, Cigna, Aetna, PHCS/Multiplan, HealthEOS, and TLC Advantage. The PHCS Network, MultiPlans PPO network, is the largest independent primary PPO in the nation. Enter your email address and we will send you a link to reset your password. Were thrilled that for almost two decades, NCQA has endorsed the processes we use to credential providers participating in the PHCS Network. As an ancillary facility such as a lab, rehab or hospice. Wayne, PA 19087610-321-1030 (tel)888-560-2447 (fax)info@imagine360.com. Changes to any demographic information for providers contracted through a group must be submitted to MultiPlan on the group's MultiPlan does not manage Medicaid plans, rather we work directly with Medicaid payors to build robust provider networks. Eagan, MN 55121. By continuing to browse, you are agreeing to our use of cookies. No Surprises Act Update: IDR Entities Will Partially Resume Issuing Payment Determinations. Authorization Submission Form. Flexible healthcare provider networks for payors, Available for commercial, Medicare Advantage, and Property and Casualty healthcare payors, Innovative contracts add value for all types of health plans. By phone: call (800) 371-2507 Online: visit www.multiplan.com/sbmapreventiveservices and follow these steps: For complete details on the scope of this review, visitwww.ncqa.org, Encouraging routine updates to ensure data quality. NCQAs website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. by providers with Doctor.com accounts when editing their profile on Doctor.com. Select Doctor or Facility search, then click continue. 3 DISLIKE REPORT Phcs Medishare Provider Portal Phcs Provider Portal Login Multiplan Portal Provider Partners Health Plan Provider Portal Provider Iasadmin Provider Portal Provider One Provider One Portal 1550 Liberty Ridge Drive We are not an insurance company. We make it easier for members to get affordable access to high-quality care when they need it through Imagine Healths partnerships with premier health systems and top-rated physicians. Home > Healthcare Providers > Our Networks. Imagine360 Administrators Did you receive an inquiry about buying MultiPlan insurance? Provider Portal . Provider self-service portal and . Bookmark it today at https://provider.multiplan.com/provider. MultiPlan is a trusted partner to over 700 healthcare payers in the commercial health, dental, government and property and casualty markets, and saves these companies more than $15 billion annually. MultiPlan PHCS network providers. MultiPlan is a trusted partner to over 700 healthcare payers in the commercial health, dental, government and property and casualty markets, and saves these companies more than $15 billion annually. As a group of 25 or more practitioners, such as an IPA or PHO. If a participation for that provider should also be confirmed before obtaining services. Enter the information for your search, then click continue to access the search results. Nationwide and Regional Primary PPO Networks, Networks Serving Government Funded Programs, Private and Employer Sponsored Health Plans. Is there a participating hospital within 25 miles of your primary practice location? Claims, Payment Policies and Other Information. For a faster response, please call us directly at 888-666-8135. Our website uses cookies. MultiPlan uses technology-enabled provider network, negotiation, claim pricing and payment accuracy services as building blocks for medical payors to customize the healthcare cost management programs that work best for them. Beech Street Providers The Beech Street Network was acquired by MultiPlan, the nation's oldest and largest supplier of independent, network-based cost management solutions, and we are working to integrate the Beech Street Network into MultiPlan's networks. All rights reserved. Provider Directory. For more information, visit multiplan.com. Contact Person, Best Time to Call or Additional Comments, 2023 MultiPlan Inc. All Rights Reserved. For more information, view our, Interoperability and Your Health Information, Selecting a health insurance plan for your employees, Report suspected health care fraud, waste or abuse, Click Here to return to the CommunityCare Life & Health PPO page. MultiPlan online application request form. The PHCS Network is available in a variety of configurations including outside the plan service area, to extend local HMO or PPO coverage nationally. MultiPlan PHCS Locating a participating provider in the PHCS network begins with the specific network logo on the front of your medical ID card. State Mandated Provider Contract Provisions, MultiPlan Practitioner Application Instructions. By continuing to use this website, you consent to these cookies. 0 Please press the Continue button to proceed. Benefit Type* Subscriber SSN or Card ID* Subscriber Group #* Patient First Name Patient Gender* Male Female Patient Date of Birth* Provider TIN or SSN*(used in billing) Planstin Administration Click on "Specific Services". We believe there is no such thing as a standard cost management approach. Please note: This network is available only outside of Oklahoma. Gravie Administrative Services LLC is a licensed Third Party Administrator that administers self-funded medical plans for employers. Best of all, it's free- no downloads required or software to install. NCQA has reviewed and Accredited the PHCS Networks Credentialing functions only. 2. To request participation in the Medicaid networks, download, fill out, and submit the form below: Our Texas True Choicenetwork is your partner in delivering care to individuals participating in Medicaid and related health plans in Texas. The PHCS Network was first certified in 2001 and has maintained NCQA certification/accreditation for ten consecutive cycles. insurance, payment options, etc. Average Overall User Rating for providers who take Multiplan PHCS: Always verify a provider's participation in the PHCS network before obtaining services. Search for a provider. NCQA is a private, nonprofit organization dedicated to improving health care quality. 2023 CommunityCare HMO, Inc. All Rights Reserved. Select Doctor or Facility search, then click continue. #8\gBLJ>[9\G For more information, visitmultiplan.com. To do this, call 844-863-6850 or call MultiPlan at 800-922-4362. 516011. Register for an account For No Surprises Act First time visitor? We are not an insurance company. Thank you for your interest in joining MultiPlans provider networks (PHCS Medicaid Network or Texas True Choice Network) serving Medicaid and related government funded programs. All rights reserved. Please locate the PHCS logo on your card and follow the corresponding instructions on this page. Do you accept direct referrals for patients? Our website uses cookies. PHCS Network MultiPlans national PPO network. For non-portal inquiries, please call 1-800-950-7040. . In accordance with our provider agreement and the Centers for Medicare and Medicaid (CMS) guidelines, we require providers participating with MultiPlan to maintain their demographic information noted below. P.O. Choose "Click here if you do not have an account" for self-registration options. XlI]Q`^ (z V3D"T$:i HBA~aS,&n !B!Lg` Providers who are non-contracted with Mass General Brigham Health Plan. MultiPlan] Author: Employee . Did you receive an inquiry about buying MultiPlan insurance? Did you receive an inquiry about buying MultiPlan insurance? If you still have questions or prefer to get help directly from an agent, please submit a request. (d/b/a PHCS Network) Credentialing functions only. LifeStance Health. We are not an insurance company. Welcome to the MultiPlan Provider Portal The portal lets you view and update your network-related information, manage tasks such as credentialing and track your customer . A self-funded health plan solution that puts members first, provides flexibility and offers savings up to 30%. Find a Medical Provider. Provider's First Name *: Provider's Middle Initial: We use cookies on this website to give you the best experience and measure website usage. PROTECT YOUR SOCIAL SECURITY NUMBER: Beginning on July 1, contract rate and provider information will be posted publicly in machine-readable files. When selecting a provider, contact the providers office to verify that they are still in-network with PHCS and that the providers billing NPI# is contracted through the PHCS/Multiplan network. As an acute care facility such as a hospital. Other physicians and providers are available in our network. Providers who are outside of Mass General Brigham Health Plan provider network can now submit medical authorization requests online. NCQA can be found online atncqa.org, on Twitter @ncqa, on Facebook atfacebook.com/NCQA.org/and on LinkedIn atlinkedin.com/company/ncqa.NCQA has reviewed and accredited Private Healthcare Systems, Inc.s. Leveraging sophisticated technology, data analytics, and a team rich with industry experience, the company interprets clients needs and customizes innovative solutions that combine its payment integrity, network-based and analyticsbased services. ! 888-581-9738 www.labcorp.com ; Quest Diagnostics ; 866-697-8378 ; www.questdiagnostics.com . These are also used for Workers Compensation and Auto Insurance programs in these areas. Did you receive an inquiry about buying MultiPlan insurance? Most popular medical specialty of providers who accept Multiplan PHCS: Family Doctor. Our website uses cookies. By using our site, you agree to our use of cookies and our, Pediatrician (Kids / Children Specialist), Gastroenterologist (Stomach & Bowel Specialist), Otolaryngologist (Ear, Nose & Throat - ENT), Physiatrist (Physical Medicine & Rehabilitation), Endocrinologist (Diabetes & Hormones Specialist), Rheumatologist (Joints & Arthritis Specialist), Plastic, Reconstructive, and Cosmetic Surgeon, General Practice Doctor (General Practitioner), Thoracic Surgeon (Cardiothoracic Vascular Surgeon), Hepatologist (Liver, Gallbladder & Pancreas), Medical Geneticist (Genetic & Hereditary Disease Specialist), Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physician Assistants & Advanced Practice Nursing Providers, Technologists, Technicians & Other Technical Service Providers, Behavioral Health & Social Service Providers, Magnetic Resonance Imaging (MRI) Specialist, Pharmacist Clinician (PhC)/ Clinical Pharmacist, Speech, Language and Hearing Service Providers. This achievement confirms the quality and consistency of the service MultiPlan offers to its clients, providers and health plan participants who use the PHCS Network. MultiPlan is committed to helping healthcare payers manage the cost of care, improve their competitiveness and inspire positive change. 2570 Foxfield, Suite 107. Explore Learn how you can add Imagine Health's provider partners to your current plan. Doctor.com has profiles for millions of doctors and other health providers in the United States, including those who take Multiplan PHCS insurance. By continuing to browse, you are agreeing to our use of cookies. u%VL:Dz;K+,{E?az9DrW{{tXk,{]Yf vto/v{?lHIVfu^I@Sbh}:!Y7mwK(N1qt8eYU6Z0_tO_ |l__=i_;:A6,yQ![lmZe[rc}R/z}o~Qml9qOte.vZRw:7U=wbxDNuq&6N#ALc!_v,/f|sY(cCZR>3]9FL)>&Bu~. As a group of less than 25 practitioners. Our website uses cookies. Discover how provider partners work with Your Health Plan. Savings have been drastic ($11 million). Case Study: Partnering to achieve certification, MultiPlan Awards $36,000 to Rural Hospitals. 2023 MultiPlan Corporation. You will be able to search by group name, facility name, dentist name, or specialty. Discover why the PPO model is failing to deliver better health outcomes.

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