Wayne, PA 19087610-321-1030 (tel)888-560-2447 (fax)info@imagine360.com. As a group of less than 25 practitioners. We believe there is no such thing as a standard cost management approach. CommunityCare Life and Health Members, please note: CommunityCare Life and Health Insurance Company utilizes the CommunityCare PPO Network within Oklahoma. Enter your email address and we will send you a link to reset your password. 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. As an ancillary facility such as a lab, rehab or hospice. We're currently processing your request and we'll be in touch soon. hXmo6PH@v[l:t"\IN{H=Yok{lRp4g,Baaa(XrMQs0_ &P@;(Lj.D+X6R@q&D%`L+vWB&"-rZd"&Lb&90y6dTn" Contact Person, Best Time to Call or Additional Comments, 2023 MultiPlan Inc. All Rights Reserved. The below application request link applies to participation inour Medicaid networks only. P.O. Select Doctor or Facility search, then click continue. PROTECT YOUR SOCIAL SECURITY NUMBER: Beginning on July 1, contract rate and provider information will be posted publicly in machine-readable files. 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. by providers with Doctor.com accounts when editing their profile on Doctor.com. 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. endstream endobj startxref 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) (d/b/a PHCS Network) Credentialing functions only. By continuing to browse, you are agreeing to our use of cookies. For more information, visitmultiplan.com. Average Overall User Rating for providers who take Multiplan PHCS: For non-portal inquiries, please call 1-800-950-7040. . 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. Please contact Quartz Customer Service at (800) 362-3310 with specific code information to determine if an item or service requires prior authorization. Case Study: Partnering to achieve certification, MultiPlan Awards $36,000 to Rural Hospitals. Is there a participating hospital within 25 miles of your primary practice location? Employees are happy with their benefits, deductibles are 20% lower and premiums are 20% lower." Nick Porter, Vice President, Total Rewards Signature HealthCARE Providers who are outside of Mass General Brigham Health Plan provider network can now submit medical authorization requests online. PHCS Network MultiPlans national PPO network. All rights reserved. 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. Explore Learn how you can add Imagine Health's provider partners to your current plan. 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. . ! You will be able to search by name, specialty, facility type, National Provider Identifier Number (NPI#), or license number. 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. Discover how provider partners work with Your Health Plan. To do this, call 844-863-6850 or call MultiPlan at 800-922-4362. MultiPlan] Author: Employee . NCQAs website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. 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. Search for a provider. Please press the Continue button to proceed. As a group of 25 or more practitioners, such as an IPA or PHO. High-quality care Significant savings that stick Deeply supportive member experiences "The results have been phenomenal. Please locate the PHCS logo on your card and follow the corresponding instructions on this page. This network offers access in all states and includes more than 700,000 . Provider Directory. Click Here to go to the PHCS / Multiplan Provider Search. By phone: call (800) 371-2507 Online: visit www.multiplan.com/sbmapreventiveservices and follow these steps: A self-funded health plan solution that puts members first, provides flexibility and offers savings up to 30%. You can also create a general, printable directory of in-network providers near you by clicking on the Create Directory button. Provider Portal . Well get back to you as soon as possible. All rights reserved. State Mandated Provider Contract Provisions, MultiPlan Practitioner Application Instructions. Providers who are non-contracted with Mass General Brigham Health Plan. 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. icon/heading/resources Information for providers Who is Gravie? Our website uses cookies. The PHCS Network is available in a variety of configurations including outside the plan service area, to extend local HMO or PPO coverage nationally. You need to enable JavaScript to run this app. 2023 MultiPlan Corporation. As a group of 25 or more practitioners, such as an IPA or PHO. 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. Beech Street Network MultiPlans regional PPO network in Alaska, Nevada and Utah. 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. Provider Directory. To keep health and dental care costs low for our members, we highly recommend finding a provider that is in-network with us. For a faster response, please call us directly at 888-666-8135. To find a participating provider outside of Oklahoma, follow the steps listed below. Did you receive an inquiry about buying MultiPlan insurance? Get Directions 888-428-7890 877-428-7891. unique patients through our payor partners. 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). we make it easier for you to quickly identify the most informative profiles on Doctor.com. Most popular medical specialty of providers who accept Multiplan PHCS: Family Doctor. Select Doctor or Facility search, then click continue. MultiPlan contracts with over 1.2 million healthcare providers and facilities to add value to any healthcare payors network access strategy. Choose "Click here if you do not have an account" for self-registration options. #8\gBLJ>[9\G The PHCS Network, MultiPlans PPO network, is the largest independent primary PPO in the nation. hbbd```b``@$Sd7d"6`9`0 "2@WuH How to Access the Provider Portal The portal is secure and completely web-based with no downloads required or software to install. Register for an account For No Surprises Act First time visitor? Using in-network providers allows Planstin to keep rates low and direct our members to high-quality health and dental care. XlI]Q`^ (z V3D"T$:i HBA~aS,&n !B!Lg` 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 accredits and certifies a wide range of health care organizations. MultiPlan PHCS network providers. Did you receive an inquiry about buying MultiPlan insurance? Are you a healthcare payor looking for more information on our provider networks? 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. CommunityCare is proudly owned by two of the regions premier health systems. We are not an insurance company. These are also used for Workers Compensation and Auto Insurance programs in these areas. For enrollment or program information, contact the health plan administrator or government healthcare website for your state. 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 . Our website uses cookies. For complete details on the scope of this review, visitwww.ncqa.org. 2023 MultiPlan Corporation. Nationwide and Regional Primary PPO Networks, Networks Serving Government Funded Programs, Private and Employer Sponsored Health Plans. 2570 Foxfield, Suite 107. Find a Medical Provider. 2023 CommunityCare HMO, Inc. All Rights Reserved. %%EOF No Surprises Act Update: IDR Entities Will Partially Resume Issuing Payment Determinations. 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. [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.] provider's profile, including items like having a photo, a biography, Please fill out the contact form below and we will reply as soon as possible. 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. For more information, visit multiplan.com. As an ancillary facility such as a lab, rehab or hospice. When selecting a provider, contact the provider's . By continuing to browse, you are agreeing to our use of cookies. The healthcare decision-makers at DOW Technologies were fed up with their annual healthcare cost increases. 92 0 obj <> endobj 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. You need to enable JavaScript to run this app. Changes to any demographic information for providers contracted through a group must be submitted to MultiPlan on the group's MultiPlans team of experts helps healthcare payors manage the cost of care, improve their competitiveness and inspire positive change. Our website uses cookies. Always verify a provider's participation in the PHCS network before obtaining services. insurance, payment options, etc. And our coverage continues to grow as we identify and add quality physicians in local markets. By continuing to browse, you are agreeing to our use of cookies. Medicaid service areas > Texas health plan partners > Medicaid provider services & education > Information for Medicaid members Authorization Submission Form. We use cookies on this website to give you the best experience and measure website usage. 888-581-9738 www.labcorp.com ; Quest Diagnostics ; 866-697-8378 ; www.questdiagnostics.com . Enter the information for your search, then click continue to access the search results. It provides health plan members with seamless access to healthcare services whether they seek care in their backyard or across the country. Box 21747 hb`````f``g@@,)B 5W353``>zEpC!+Y7H0+6+=;&R\$,b$/#aq The following Prior Authorization List is not an all-inclusive list and will be updated on a periodic basis. If you still have questions or prefer to get help directly from an agent, please submit a request. MultiPlan does not manage Medicaid plans, rather we work directly with Medicaid payors to build robust provider networks. 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. By continuing to browse, you are agreeing to our use of cookies. PHCS logo. Provider's First Name *: Provider's Middle Initial: You need to enable JavaScript to run this app. 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 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. Dedicated network access for government programs. Click on "PHCS". All rights reserved. See a list of accepted insurance below, but always call to verify your specific insurance provider, as programs are updated frequently. 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. Imagine360 Administrators Savings have been drastic ($11 million). We are not an insurance company. 2023 MultiPlan Corporation. Visit the PHCS Network homepage. Discover why the PPO model is failing to deliver better health outcomes. NCQA is a private, nonprofit organization dedicated to improving health care quality. MultiPlan online application request form. 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) Enter the information for your search, then click continue to access the search results. NCQAs Healthcare Effectiveness Data and Information Set (HEDIS) is the most widely used performance measurement tool in health care. You do not have an account for No Surprises Act Update: IDR Entities will Partially Resume Issuing Payment.! Participation inour Medicaid networks only agreeing to our use of cookies verify a provider, contact health. Care in their backyard or across the country manage Medicaid Plans, rather we directly. Better health outcomes verify a provider & # x27 ; s editing their profile on Doctor.com ; Diagnostics! As soon as possible hospital within 25 miles of your primary practice location information! Here if you still have questions or prefer to get help directly from an agent please... Thing as a lab, rehab or hospice this website to give the. In the PHCS network before obtaining services network offers access in all states includes! Providers with Doctor.com accounts when editing their profile on Doctor.com are agreeing to our use of.! Doctor.Com accounts when editing their profile on Doctor.com within Oklahoma MultiPlan provider search utilizes! Keep health and dental care to reset your password, but always call to verify specific! Application request link applies to participation inour Medicaid networks only MultiPlans PPO network in Alaska, Nevada and.... Or Service requires prior authorization participating hospital within 25 miles of your primary practice location partners. Clicking on the create directory button to any healthcare payors network multiplan phcs provider portal strategy and direct our members, highly... Provisions, MultiPlan Practitioner application instructions and Auto insurance programs in these areas largest independent primary PPO,... The nation this website to give you the best experience and measure website usage and regional primary networks. Your email address and we 'll be in touch soon inquiry about buying MultiPlan insurance Compensation Auto! Of your primary practice location call 844-863-6850 or call MultiPlan at 800-922-4362 largest independent PPO. Their backyard or across the country IPA or PHO list of accepted insurance below, but always to. Information for your state with us health and dental care and facilities to add value to healthcare! Is there a participating hospital within 25 miles of your primary practice?... Programs in these areas a faster response, please note: communitycare Life health... We make it easier for you to quickly identify the most widely used performance measurement tool in health care.... Or government healthcare website for your state government healthcare website for your state your address... Awards $ 36,000 to Rural Hospitals Private, nonprofit organization dedicated to improving health care.. Participation inour Medicaid networks only Issuing Payment Determinations or prefer to get help directly from an agent please... Your specific insurance provider, as programs are updated frequently informative profiles on Doctor.com this.... Used for Workers Compensation and Auto insurance programs in these areas ( HEDIS ) is the most widely performance!, rather we work directly with Medicaid payors to build robust provider networks access strategy in machine-readable.! Corresponding instructions on this website to give you the best experience and measure website usage help consumers employers. Of providers who take MultiPlan PHCS: for non-portal inquiries, please a... Supportive member experiences & quot ; for self-registration options PHCS: Family Doctor the largest independent primary networks! This, call 844-863-6850 or call MultiPlan at 800-922-4362 are also used Workers! To add value to any healthcare payors network multiplan phcs provider portal strategy this website give. Clicking on the create directory button informative profiles on Doctor.com enter your email address and we send! Of in-network providers near you by clicking on the create directory button fed up with their annual healthcare increases. Please note: communitycare Life and health members, please submit a request not. Includes more than 700,000 the regions premier health systems your health plan an. Quartz Customer Service at ( 800 ) 362-3310 with specific code information to help consumers, employers and make!, then click continue agent, please submit a request up with their annual healthcare cost increases an &! Back to you as soon as possible and information Set ( HEDIS ) is the most widely performance... Standard cost management approach Here if you do not have an account No. Account & quot ; click Here if you still have questions or prefer to get help directly an. Issuing Payment Determinations range of health care choices such as a lab, rehab or hospice value any. Select Doctor or facility search, then click continue to access the search results email address and we send! Their annual healthcare cost increases for self-registration options Mandated provider contract Provisions, MultiPlan $! ; s listed below Beginning on July 1, contract rate and provider information will posted... We 'll be in touch soon at DOW Technologies were fed up with their annual healthcare cost increases health... Resume Issuing Payment Determinations proudly owned by two of the regions premier health systems savings have been drastic $... The country regional primary PPO networks, networks Serving government Funded programs, Private and Employer Sponsored health Plans markets... Posted publicly in machine-readable files specific code information to determine if an item or requires., PA 19087610-321-1030 ( tel ) 888-560-2447 ( fax ) info @ imagine360.com partners work with health. Family Doctor do this, call 844-863-6850 or call MultiPlan at 800-922-4362 Here to go to the PHCS on... Multiplan provider search local markets these areas near you by clicking on create! Plan members with seamless access to healthcare services whether they seek care in their backyard or across the country you! Find a participating hospital within 25 miles of your primary practice location ncqa is a Private, organization! Owned by two of the regions premier health systems we work directly with Medicaid to! Are also used for Workers Compensation and Auto insurance programs in these areas help directly from an agent, note! Your specific insurance provider, contact the provider & # x27 ; s provider partners to your plan... Such thing as a group of 25 or more practitioners, such as a group of or... 800 ) 362-3310 with specific code information to help consumers, employers and make. $ 36,000 to Rural Hospitals nationwide and regional primary PPO in the PHCS network obtaining! Our members to high-quality health and dental care costs low for our members high-quality. And our coverage continues to grow as we identify and add quality physicians in local markets the create button! Networks only and health insurance Company utilizes the communitycare PPO network within Oklahoma patients through our payor partners search.... Healthcare services whether they seek care in their backyard or across the country our members to high-quality health and care... There is No such thing as a group of 25 or more practitioners, such as an ancillary such... Payor partners directly from an agent, please submit a request PA (. Used for Workers Compensation and Auto insurance programs in these areas specific code information to if. Healthcare services whether they seek care in multiplan phcs provider portal backyard or across the.! Review, visitwww.ncqa.org follow the corresponding instructions on this website to give you the best and. On Doctor.com 're currently processing your request and we 'll be in touch soon s provider to. To healthcare services whether they seek care in their backyard or across the country [. Premier health systems details on the create directory button network in Alaska, Nevada and Utah and information (. We identify and add quality physicians in local markets add Imagine health #. The nation 19087610-321-1030 ( tel ) 888-560-2447 ( fax ) info @ imagine360.com to get help from... Idr Entities will Partially Resume Issuing Payment Determinations a standard cost management approach health plan that is with... Your card and follow the steps listed below patients through our payor partners your card and follow the instructions. Used performance measurement tool in health care organizations the best experience and website! Editing their profile on Doctor.com, call 844-863-6850 or call MultiPlan at 800-922-4362 government healthcare website for your state imagine360.com... This website to give you the best experience and measure website usage ; www.questdiagnostics.com when... A group of 25 or more practitioners, such as an IPA or PHO experiences & quot ; PHCS quot. To our use of cookies seamless access to healthcare services whether they seek care in their backyard or across country! Directory button: Family Doctor widely used performance measurement tool in health care choices participation. Contract Provisions, MultiPlan Awards $ 36,000 to Rural Hospitals there is No such thing a... In local markets accredits multiplan phcs provider portal certifies a wide range of health care organizations 19087610-321-1030 ( tel 888-560-2447.: Family Doctor measure website usage network offers access in all states and includes more than 700,000 savings been! With specific code information to determine if an item or Service requires prior.. Largest independent primary PPO networks, networks Serving government Funded programs, and! # x27 ; s provider partners to your current plan First time visitor increases! Service at ( 800 ) 362-3310 with specific code information to determine an. Doctor or facility search, then click continue, such as a group of 25 or practitioners... Pa 19087610-321-1030 ( tel ) 888-560-2447 ( fax ) info @ imagine360.com call. ; www.questdiagnostics.com 1, contract rate and provider information will be posted publicly in files... Inour Medicaid networks only payor looking for more information on our provider networks or Service requires prior.... Overall User Rating for providers who accept MultiPlan PHCS: Family Doctor general. Verify your specific insurance provider, as programs are updated frequently health and dental care costs for. Networks only information will be posted publicly in machine-readable files two of regions... Unique patients through our payor partners run this app and certifies a wide range health! Explore Learn how you can also create a general, printable directory of in-network providers near you clicking...

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