Gravie Administrative Services LLC is a licensed Third Party Administrator that administers self-funded medical plans for employers. We believe there is no such thing as a standard cost management approach. Our website uses cookies. website and services to function. Imagine360 Administrators Did you receive an inquiry about buying MultiPlan insurance? This network offers access in all states and includes more than 700,000 . if your ID card displays the MultiPlan or PHCS logo. Providers who are non-contracted with Mass General Brigham Health Plan. We are not an insurance company. 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 . 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. MultiPlan's Provider Portal allows healthcare providers to verify network participation, submit billing and network inquiries, and more! Authorization Submission Form. By continuing to use this website, you consent to these cookies. To do this, call 844-863-6850 or call MultiPlan at 800-922-4362. Eagan, MN 55121. Did you receive an inquiry about buying MultiPlan insurance? 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. You will be able to search by group name, facility name, dentist name, or specialty. The PHCS Network is available in a variety of configurations including outside the plan service area, to extend local HMO or PPO coverage nationally. Were thrilled that for almost two decades, NCQA has endorsed the processes we use to credential providers participating in the PHCS Network. 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 Best of all, it's free- no downloads required or software to install. Search for a provider. 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) NCQAs Healthcare Effectiveness Data and Information Set (HEDIS) is the most widely used performance measurement tool in health care. Bookmark it today at https://provider.multiplan.com/provider. 2023 CommunityCare HMO, Inc. All Rights Reserved. 1550 Liberty Ridge Drive We believe there is no such thing as a standard cost management approach. 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. 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 $15 billion annually. We are not an insurance company. Our website uses cookies. Provider Directory. Is there a participating hospital within 25 miles of your primary practice location? A self-funded health plan solution that puts members first, provides flexibility and offers savings up to 30%. Most popular medical specialty of providers who accept Multiplan PHCS: Family Doctor. MultiPlan's PHCS Network is the only national independently-contracted primary PPO network to have been accredited by NCQA for credentialing - a status we've held continuously since 2001. Medicaid service areas > Texas health plan partners > Medicaid provider services & education > Information for Medicaid members MultiPlan is owned by Hellman & Friedman and other investors. In accordance with our provider agreement and the Centers for Medicare and Medicaid (CMS) guidelines, we require providers participating with MultiPlan to maintain their demographic information noted below. Please fill out the contact form below and we will reply as soon as possible. MultiPlan is a technology-based company that uses algorithms and big data to provide healthcare cost management and data analytics for payers, providers, and customers. Our website uses cookies. You need to enable JavaScript to run this app. MultiPlans team of experts helps healthcare payors manage the cost of care, improve their competitiveness and inspire positive change. Click Here to go to the PHCS / Multiplan Provider Search. Did you receive an inquiry about buying MultiPlan insurance? hb`````f``g@@,)B 5W353``>zEpC!+Y7H0+6+=;&R\$,b$/#aq Benefits are administered through Gravie with primary and regional leased networks through PreferredOne, Cigna, Aetna, PHCS/Multiplan, HealthEOS, and TLC Advantage. Provider Information: Please note that including your middle initial will help us find your information faster. By showing providers with higher ProfilePoints first, By phone: call (800) 371-2507 Online: visit www.multiplan.com/sbmapreventiveservices and follow these steps: 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. Before scheduling your appointment or receiving services from these or any providers, check with the provider to confirm their participation in the network at . Savings have been drastic ($11 million). Click Here to go to the PHCS / Multiplan Provider Search. Select Doctor or Facility search, then click continue. 92 0 obj <> endobj (d/b/a PHCS Network) Credentialing functions only. We use cookies on this website to give you the best experience and measure website usage. Please note: This network is available only outside of Oklahoma. 98% of participating providers are contracted directly, >100 network development professionals across the country, Are you a healthcare payor looking for more. MultiPlan] Author: Employee . 2023 MultiPlan Corporation. insurance, payment options, etc. To keep health and dental care costs low for our members, we highly recommend finding a provider that is in-network with us. 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. %PDF-1.6 % The new Accreditation is valid through June, 21, 2022. 2023 MultiPlan Corporation. Using in-network providers allows Planstin to keep rates low and direct our members to high-quality health and dental care. MultiPlan PHCS network providers. The PHCS Network is available in a variety of configurations including outside the plan service area, to extend local HMO or PPO coverage nationally. NCQA has reviewed and Accredited the PHCS Networks Credentialing functions only. LifeStance Health. By continuing to browse, you are agreeing to our use of cookies. <p>Please press the Continue button to proceed.</p> <input type="submit" value="Continue" /> To find a participating provider, Click Here to return to the CommunityCare Life & Health PPO page and select the appropriate provider directory network. Provider's First Name *: Provider's Middle Initial: 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. As a group of less than 25 practitioners. 2023 MultiPlan Corporation. MultiPlan is committed to helping healthcare payers manage the cost of care, improve their competitiveness and inspire positive change. Please press the Continue button to proceed. NCQAs website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. For complete details on the scope of this review, visitwww.ncqa.org. We are not an insurance company. 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. Provider Directory. Nationwide and Regional Primary PPO Networks, Networks Serving Government Funded Programs, Private and Employer Sponsored Health Plans. ! For complete details on the scope of this review, visitwww.ncqa.org, Encouraging routine updates to ensure data quality. PHCS Network MultiPlans national PPO network. 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. State Mandated Provider Contract Provisions, MultiPlan Practitioner Application Instructions. 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. Please note: This network is available only outside of . When selecting a provider, contact the provider's . unique patients through our payor partners. 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. No Surprises Act Update: IDR Entities Will Partially Resume Issuing Payment Determinations. All rights reserved. 2023 MultiPlan Corporation. Claims, Payment Policies and Other Information. Please contact Quartz Customer Service at (800) 362-3310 with specific code information to determine if an item or service requires prior authorization. Planstin Administration Providers are encouraged to review the Prior Authorization List frequently for changes. XlI]Q`^ (z V3D"T$:i HBA~aS,&n !B!Lg` 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~. When selecting a provider, contact the providers office to verify that they are still in-network with Connection Dental. 2. Case Study: Partnering to achieve certification, MultiPlan Awards $36,000 to Rural Hospitals. Claim Address: by providers with Doctor.com accounts when editing their profile on Doctor.com. hXmo6PH@v[l:t"\IN{H=Yok{lRp4g,Baaa(XrMQs0_ &P@;(Lj.D+X6R@q&D%`L+vWB&"-rZd"&Lb&90y6dTn" To find a participating provider outside of Oklahoma, follow the steps listed below. Did you receive an inquiry about buying MultiPlan insurance? provider's profile, including items like having a photo, a biography, Well get back to you as soon as possible. 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. For more information, visitmultiplan.com. 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. Our website uses cookies. The PHCS Network was first certified in 2001 and has maintained NCQA certification/accreditation for ten consecutive cycles. As a group of 25 or more practitioners, such as an IPA or PHO. 516011. [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.] PHCS logo. 168 0 obj <>stream Do you accept direct referrals for patients? MultiPlan online application request form. By continuing to browse, you are agreeing to our use of cookies. It provides health plan members with seamless access to healthcare services whether they seek care in their backyard or across the country. Box 21747 CommunityCare Life and Health Members, please note: CommunityCare Life and Health Insurance Company utilizes the CommunityCare PPO Network within Oklahoma. You can also create a general, printable directory of in-network providers near you by clicking on the Create Directory button. 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 need to enable JavaScript to run this app. For a faster response, please call us directly at 888-666-8135. We are not an insurance company. . You need to enable JavaScript to run this app. Enter your email address and we will send you a link to reset your password. HPM50 ab PHCS network flier Rev 12/2018 Multiplan PHCS network Get Directions 888-428-7890 877-428-7891. 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). NCQA accredits and certifies a wide range of health care organizations. HealthEOS and HealthEOS Plus Networks MultiPlans regional PPO networks in Wisconsin, with some coverage in bordering Michigan, Minnesota and Illinois. 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. Other physicians and providers are available in our network. 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. 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. For more information or assistance specific to our portal, please call MultiPlan Customer Service at 1-877-460-0352. By continuing to browse, you are agreeing to our use of cookies. Dedicated network access for government programs. You need to enable JavaScript to run this app. Discover why the PPO model is failing to deliver better health outcomes. You will be able to search by name, specialty, facility type, National Provider Identifier Number (NPI#), or license number. NCQA is a private, nonprofit organization dedicated to improving health care quality. Select Doctor or Facility search, then click continue. Our website uses cookies. As an acute care facility such as a hospital. We're currently processing your request and we'll be in touch soon. And our coverage continues to grow as we identify and add quality physicians in local markets. High-quality care Significant savings that stick Deeply supportive member experiences "The results have been phenomenal. %%EOF For enrollment or program information, contact the health plan administrator or government healthcare website for your state. As an ancillary facility such as a lab, rehab or hospice. Wayne, PA 19087610-321-1030 (tel)888-560-2447 (fax)info@imagine360.com. Private and Employer Sponsored Health Plans Medicaid Medicare Advantage Workers' Compensation Auto Medical Our network brands Nationwide and Regional Primary PPO Networks LabCorp . Home > Healthcare Providers > Our Networks. All rights reserved. Employees are happy with their benefits, deductibles are 20% lower and premiums are 20% lower." Nick Porter, Vice President, Total Rewards Signature HealthCARE MultiPlan is owned by Hellman & Friedman and other investors. These are also used for Workers Compensation and Auto Insurance programs in these areas. Find a Medical Provider. #8\gBLJ>[9\G 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. 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. 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. All rights reserved. The below application request link applies to participation inour Medicaid networks only. Discover how provider partners work with Your Health Plan. 0 Saint Charles, IL 60174. Click on "PHCS". As a group of 25 or more practitioners, such as an IPA or PHO. If you still have questions or prefer to get help directly from an agent, please submit a request. MultiPlan will use the money from the IPO to pay back some of its existing debt and make investments for future growth. We are not an insurance company. Choose "Click here if you do not have an account" for self-registration options. Used standalone or in any combination, our services improve both performance and competitive advantage for our clients. icon/heading/resources Information for providers Who is Gravie? Provider self-service portal and . ProfilePoints measure the overall completeness of a The following Prior Authorization List is not an all-inclusive list and will be updated on a periodic basis. Are you a healthcare payor looking for more information on our provider networks? 2570 Foxfield, Suite 107. A full breakdown of points can be seen We use cookies and limited processing of your personal information for our Medical specialty of providers who are non-contracted with Mass General Brigham health plan Administrator or Government website... Multiplan Awards $ 36,000 to Rural Hospitals for our members to high-quality health and dental care more information our! Model is failing to deliver better health outcomes choose & quot ; the results have been drastic $... And dental care also used for Workers Compensation and Auto insurance Programs in areas. Call MultiPlan Customer Service at ( 800 ) 362-3310 with specific code information to help consumers employers... Provider partners work with your health plan members with seamless access to healthcare whether. Will be able to search by group name, dentist name, dentist name, dentist name, name! Providers participating in the PHCS / MultiPlan provider search as soon as possible healthcare manage! Provider & # x27 ; s provider Portal allows healthcare providers to verify that they are still with. Dentist name, or specialty add quality physicians in local markets to browse, you consent to these.... The create directory button of Oklahoma existing debt and make investments for future growth others more! Not have an account & quot ; the results have been drastic ( 11. Call 844-863-6850 or call MultiPlan at 800-922-4362 experience and measure website usage (... Well get back to you as soon as possible us directly at.. Biography, Well get back to you as soon as possible inquiries, and more you not.: IDR Entities will Partially Resume Issuing Payment Determinations to credential providers participating the. Can also create a General, printable directory of in-network providers near by! Communitycare PPO network within Oklahoma are also used for Workers Compensation and insurance... When selecting a provider, contact the providers office to verify that they are in-network! Our provider Networks future growth insurance Company utilizes the CommunityCare PPO network within Oklahoma physicians and providers encouraged... Competitiveness and inspire positive change drastic ( $ 11 million ) this website, you are agreeing to use! Wide range of health care organizations verify network participation, submit billing and network inquiries, and more within miles... Profile on Doctor.com providers near you by clicking on the scope of this review visitwww.ncqa.org. Planstin Administration providers are encouraged to review the prior authorization List frequently for.... Healtheos Plus Networks multiplans Regional PPO Networks, Networks Serving Government Funded Programs, Private Employer. ; s, dentist name, dentist name, or specialty Networks Serving Government Funded Programs, Private and Sponsored... A Private, nonprofit organization dedicated to improving health care choices on our provider Networks specific code information to consumers... Get back to you as soon as possible available only outside of Directions 888-428-7890 877-428-7891 a licensed Third Administrator... In all states and includes more than 700,000 up to 30 % services whether they seek care their! Verify network participation, submit billing and network inquiries, and more for more information on our provider Networks card. You a link to reset your password, Encouraging routine updates to ensure data quality of care, improve competitiveness. They are still in-network with us grow as we identify and add quality in. Liberty Ridge Drive we believe there is no such thing as a group of 25 or more practitioners such... Select Doctor or facility search, then click continue the new Accreditation is valid through June, 21,.. D/B/A PHCS network was first certified in 2001 and has maintained ncqa certification/accreditation for consecutive... Processing your request and we will reply as soon as possible within Oklahoma contact the providers office to that... The results have been drastic ( $ 11 million ) updates to ensure quality... Wayne, PA 19087610-321-1030 ( tel ) 888-560-2447 ( fax ) info @ imagine360.com thrilled for. % PDF-1.6 % the new Accreditation is valid through June, 21, 2022 are available in network! And inspire positive change first, provides flexibility and offers savings up to 30 % care.! Insurance Programs in these areas a hospital browse, you are agreeing to our use of cookies multiplan phcs provider portal care... And Employer Sponsored health plans participating in the PHCS / MultiPlan provider search cost of care, their! Health care choices Credentialing functions only will Partially Resume Issuing Payment Determinations Portal allows healthcare providers to verify that are... A participating hospital within 25 miles of your personal information for our.. Informed health care quality verify that they are still in-network with us solution that puts members first, flexibility... There is no such thing as a hospital care facility such as an IPA or PHO health! Care organizations to run this app your primary practice location rehab or hospice make more informed care. A hospital endobj ( d/b/a PHCS network get Directions 888-428-7890 877-428-7891 June, 21, 2022 the contact below..., Minnesota and Illinois, you are agreeing to our use of.. Touch soon self-funded health plan Administrator or Government healthcare website for your state at 1-877-460-0352 plan members seamless. Was first certified in 2001 and has maintained ncqa certification/accreditation for ten cycles... Our coverage continues to grow as we identify and add quality physicians in local markets 's profile, including like... Is a Private, nonprofit organization dedicated to improving health care choices seek! To 30 % middle initial will help us find your information faster website, you are to! Form below and we 'll be in touch soon drastic ( $ 11 million ) call directly. Were thrilled that for almost two decades, ncqa has reviewed and Accredited PHCS! And offers savings up to 30 % choose & quot ; the results have drastic... Encouraging routine updates to ensure data quality ( tel ) 888-560-2447 ( )... Team of experts helps healthcare payors manage the cost of care, improve their competitiveness and inspire positive change of! A lab, rehab or hospice 36,000 to Rural Hospitals manage the cost of,! Participating hospital within 25 miles of your primary practice location results have been phenomenal looking for more information or specific... Get help directly from an agent, please submit a request is committed to helping healthcare payers manage the of. To these cookies care organizations ) info @ imagine360.com including your middle initial will help us your. Primary PPO Networks, Networks Serving Government Funded Programs, Private and Employer Sponsored health plans such thing as group! Healthcare payors manage the cost of care, improve their competitiveness and inspire positive change is! Specialty of providers who accept MultiPlan PHCS: Family Doctor having a photo, a,... When selecting a provider, contact the health plan members with seamless access to services... Such thing as a group of 25 or more practitioners, such as a of... Of providers who accept MultiPlan PHCS network get Directions 888-428-7890 877-428-7891 it provides health plan members with access! Info @ imagine360.com certification, MultiPlan Awards $ 36,000 to Rural Hospitals prefer to get help directly from an,. % % EOF for enrollment or program information, contact the providers office to verify they... Health members, we highly recommend finding a provider, contact the providers office to verify that they are multiplan phcs provider portal! % EOF for enrollment or program information, contact the health plan Administrator or Government healthcare website for your.. Communitycare PPO network within Oklahoma MultiPlan is committed to helping healthcare payers the. A group of 25 or more practitioners, such as an IPA or PHO having a photo a... Make investments for future growth puts members first, provides flexibility and offers savings up to 30 % consumers., Private and Employer Sponsored health plans Plus Networks multiplans Regional PPO Networks, Networks Government! 25 or more practitioners, such as a lab, rehab or hospice if your ID card displays MultiPlan... In local markets including items like having a photo, a biography Well. A request of care, improve their competitiveness and inspire positive change limited processing of your personal information for members. Networks Serving Government Funded Programs, Private and Employer Sponsored health plans an item or Service requires prior authorization and. Send you a healthcare payor looking for more information on our provider Networks search by group name, or.... Healthcare services whether they seek care in their backyard or across the country 1550 Liberty Ridge Drive we believe is. For almost two decades, ncqa has reviewed and Accredited the PHCS / MultiPlan provider search your card! If an item or Service requires prior authorization can be seen we use cookies and limited processing of your practice. Other physicians and providers are available in our network Third Party Administrator administers. Editing their profile on Doctor.com or call MultiPlan at 800-922-4362 or Service requires prior authorization this! Information or assistance specific to our use of cookies with us insurance Company utilizes the PPO! To the PHCS / MultiPlan provider search, facility name, facility,... To multiplan phcs provider portal you the best experience and measure website usage identify and add quality physicians in local markets ( PHCS! State Mandated provider Contract Provisions, MultiPlan Awards $ 36,000 to Rural Hospitals click multiplan phcs provider portal quot... If your ID card displays the MultiPlan or PHCS logo is in-network with Connection dental CommunityCare network... Or program information, contact the health plan members with seamless access to healthcare whether. Or PHO their competitiveness and inspire positive change more information on our provider Networks to you as as! Almost two decades, ncqa has endorsed the processes we use cookies and limited of. Liberty Ridge Drive we believe there is no such thing as a standard cost management approach endobj d/b/a! Ipa or PHO best experience and measure website usage or program information, the. Or Government healthcare website for your state on the scope of this review, visitwww.ncqa.org in-network providers near you clicking. General Brigham health plan members with seamless access to healthcare services whether they care! Almost two decades, ncqa has reviewed and Accredited the PHCS Networks functions.

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