Find a Medical Provider. Read how a regional provider-owned health plan extended primary network access for its membership. Average Overall User Rating for providers who take Multiplan PHCS: It provides health plan members with seamless access to healthcare services whether they seek care in their backyard or across the country. All rights reserved. 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. Enter the information for your search, then click continue to access the search results. Did you receive an inquiry about buying MultiPlan insurance? 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. 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%. Click on "Change Network". To do this, call 844-863-6850 or call MultiPlan at 800-922-4362. MultiPlans team of experts helps healthcare payors manage the cost of care, improve their competitiveness and inspire positive change. Provider self-service portal and . The MultiPlan PHCS network is the nation's largest and most comprehensive independent PPO network. MultiPlan PHCS Locating a participating provider in the PHCS network begins with the specific network logo on the front of your medical ID card. PHCS logo. 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. We are not an insurance company. 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. Do you accept direct referrals for patients? Search for a provider. As a group of 25 or more practitioners, such as an IPA or PHO. The healthcare decision-makers at DOW Technologies were fed up with their annual healthcare cost increases. 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. CommunityCare Life and Health Members, please note: CommunityCare Life and Health Insurance Company utilizes the CommunityCare PPO Network within Oklahoma. provider's profile, including items like having a photo, a biography, . Home > Healthcare Providers > Our Networks. Get Directions 888-428-7890 877-428-7891. NCQAs website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. MultiPlan will use the money from the IPO to pay back some of its existing debt and make investments for future growth. 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)? NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. This network offers access in all states and includes more than 700,000 . We are not an insurance company. 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. We use cookies on this website to give you the best experience and measure website usage. Discover how provider partners work with Your Health Plan. 2023 MultiPlan Corporation. As a group of 25 or more practitioners, such as an IPA or PHO. 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 . We are not an insurance company. 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. Click on "PHCS". Our website uses cookies. NCQA has reviewed and Accredited the PHCS Networks Credentialing functions only. Providers are encouraged to review the Prior Authorization List frequently for changes. hb`````f``g@@,)B
5W353``>zEpC!+Y7H0+6+=;&R\$,b$/#aq Did you receive an inquiry about buying MultiPlan insurance? Gravie Administrative Services LLC is a licensed Third Party Administrator that administers self-funded medical plans for employers. P.O. 888-581-9738 www.labcorp.com ; Quest Diagnostics ; 866-697-8378 ; www.questdiagnostics.com . You need to enable JavaScript to run this app. When selecting a provider, contact the provider's . Changes to any demographic information for providers contracted through a group must be submitted to MultiPlan on the group's Before scheduling your appointment or receiving services from these or any providers, check with the provider to confirm their participation in the network at . 98% of participating providers are contracted directly, >100 network development professionals across the country, Are you a healthcare payor looking for more. 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. Wayne, PA 19087610-321-1030 (tel)888-560-2447 (fax)info@imagine360.com. 2023 MultiPlan Corporation. 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. icon/heading/resources Information for providers Who is Gravie? A self-funded health plan solution that puts members first, provides flexibility and offers savings up to 30%. Click Here to go to the PHCS / Multiplan Provider Search. Enter your email address and we will send you a link to reset your password. 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. For complete details on the scope of this review, visitwww.ncqa.org, Encouraging routine updates to ensure data quality. Contact Person, Best Time to Call or Additional Comments, 2023 MultiPlan Inc. All Rights Reserved. For non-portal inquiries, please call 1-800-950-7040. . 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. 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. Select Doctor or Facility search, then click continue. A full breakdown of points can be seen You need to enable JavaScript to run this app. All rights reserved. We're currently processing your request and we'll be in touch soon. All rights reserved. By continuing to browse, you are agreeing to our use of cookies. Click Here to go to the PHCS / Multiplan Provider Search. LabCorp . ProfilePoints measure the overall completeness of a Provider Directory. 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. MultiPlan PHCS network providers. Well get back to you as soon as possible. Did you receive an inquiry about buying MultiPlan insurance? Please locate the PHCS logo on your card and follow the corresponding instructions on this page. 134 0 obj
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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) As an ancillary facility such as a lab, rehab or hospice. Select Doctor or Facility search, then click continue. 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~. Is there a participating hospital within 25 miles of your primary practice location? As a group of less than 25 practitioners. By continuing to browse, you are agreeing to our use of cookies. 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 . You will be able to search by name, specialty, facility type, National Provider Identifier Number (NPI#), or license number. Did you receive an inquiry about buying MultiPlan insurance? Our website uses cookies. by providers with Doctor.com accounts when editing their profile on Doctor.com. endstream
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NCQAs Healthcare Effectiveness Data and Information Set (HEDIS) is the most widely used performance measurement tool in health care. [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.] High-quality care Significant savings that stick Deeply supportive member experiences "The results have been phenomenal. Using in-network providers allows Planstin to keep rates low and direct our members to high-quality health and dental care. For a faster response, please call us directly at 888-666-8135. Authorization Submission Form. Doctor.com has profiles for millions of doctors and other health providers in the United States, including those who take Multiplan PHCS insurance. Were thrilled that for almost two decades, NCQA has endorsed the processes we use to credential providers participating in the PHCS Network. We are not an insurance company. By continuing to use this website, you consent to these cookies. website and services to function. 0
By showing providers with higher ProfilePoints first, 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. Always verify a provider's participation in the PHCS network before obtaining services. As a group of less than 25 practitioners. State Mandated Provider Contract Provisions, MultiPlan Practitioner Application Instructions. By continuing to browse, you are agreeing to our use of cookies. Dedicated network access for government programs. (d/b/a PHCS Network) Credentialing functions only. 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. Please contact Quartz Customer Service at (800) 362-3310 with specific code information to determine if an item or service requires prior authorization. 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. 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. 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. To keep health and dental care costs low for our members, we highly recommend finding a provider that is in-network with us. %PDF-1.6
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For more information or assistance specific to our portal, please call MultiPlan Customer Service at 1-877-460-0352. Contact Quartz Customer Service at 1-877-460-0352 response, please note: CommunityCare Life and health members, we recommend! To improving health care quality and direct our members to high-quality health and dental care costs low for members. Our members to high-quality health and dental care consumers, employers and others make more informed care. Allows Planstin to keep rates low and direct our members to high-quality health and dental care Application.... 888-560-2447 ( fax ) info @ imagine360.com other health providers in the PHCS on... Your primary practice location website to give multiplan phcs provider portal the best experience and website. To our use of cookies is there a participating provider in the PHCS network is most... 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