Managed Care Services  

Prime Health Services Offers International PPO Network

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The world has changed!  No longer do we live in a world where business is limited to just the country where we live or work.  Today, particularly in the USA, we are finding that businesses are doing more and more work abroad, outsourcing.  Thus, more employees are traveling between countries.  Because business is conducted across the world, unfortunately, it does not mean that illness and work injuries stay at home.  Medical care is needed and sought by these employees while they are out of the United States.

With this being the case, what happens to  medical claims when they are received for payment?  Many companies pay them at full charges. This is a needless waste of money.  Savings can be obtained on these type claims, and Prime Health Services has the solution.

Prime Health, in conjunction with its partners worldwide, is currently developing and expanding our International PPO Network.  This network, is more costly than a domestic PPO's access and offers coverage in some 115 countries today. This coverage is primarily in the Caribbean states, Mexico, Central America, South America, Spain, England, France, and with limited coverage in India.   We are working to expand into the orient and hope to have progress there in the future.

How the program works:    A ll claims must be submitted directly to Prime Health Services for processing.  Why?  Well in many of these countries there are no PPO networks as we understand them in the USA.  They are not billing with standardized codes, and in many cases we are required, with our partner networks, to negotiate each claim individually.  Generally, this will result in significant discounts and requires the Payor to issue payment in an expedited manner (as quick payment is one of the negotiation tools used to get a savings).  Also, In some countries, payment is required at time of service.  India would be one example.  So it is important to allow Prime Health Services to assist in coordinating the referral and admission.  Patients identifying themselves at these facilities can get the discount at admission, and Prime Health can settle with the client later for such access.

Prime Health Services is excited about our International PPO Network development and we stand ready to make customizations of our offerings to meet our clients needs.  If you have questions, please do not hesitate to contact our business development department at 1-866-348-3887 for additional information.

www.prime-health.net

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Apollo Hospitals of India Joins PHS PPO

Prime Health Services is proud to announce the expansion of our International PPO Network offering by forming a relationship with the Indraprastha Medical Corporation Limited (IMCL).   IMCL is the operator of the Apollo Hospitals in India, which is the first chain of hospitals to be certified by the Joint Commission – International USA.  These state of the art facilities offer the latest in technology and the best trained American Board Certified physicians available.  Not to mention, the prices cannot be beat, and because of the participation in the Prime Health Services International PPO Network offering, even more savings is available!

The Nine (9) Apollo Facilities include the following locations…

Indraprastha Apollo Hospitals
Sarita Vihar, Mathura Road
NEW DELHI - 110 076
Tel: +91-011 - 26925801/26925858
Fax: +91-011-26823629
Website: www.apollohospdelhi.com

Apollo Hospitals
21, Greams Lane Off Greams Road
CHENNAI 600 006
Tel: +91-044- 28293333 / 28290200
Fax: +91-044-2834429
Website: www.apollohospitals.com

Apollo Hospitals
Jubilee Hills, HYDERABAD - 500033
Tel: +91-40-23607777
FAX: +91-40-23608050
email: apollohyde@apololife.com

Apollo Gleneagles Hospitals Limited
No. 58, Canal Circular Road
Kolkatta – 700 054
Tel: +91-033-2585208/2585217
Website: www.apollogleneagles.com

Akshaya Apollo Hospitals Limited
Plot No. 1A , Bhat GIDC Estate
Gandhinagar, Gujarat -382428
Tel: +91-079 - 3969209
email: akshayaapollo@icenet.net

Apollo Heart & Kidney Center
10-50-80, WALTAIR MAIN ROAD
VISHAKPATNAM - 530002
Ph: 0891- 2529618/19/20/21/22
FAX: 0891 -2560858
Website: www.apollohospitalgroup.com

Apollo Hospitals
Seepat Road, BILASPUR - 495 006
Tel: +91-07752-243300
Website: www.apollobilaspur.com

Apollo Hospitals Colombo
COLOMBO - 5
Ph: +91-074-530000
FAX: +91-074-511199
Email: apollohosplanka@dialogsl.net

Website: www.apollocolombo.com

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Why Prime Health PPO?

by Bryan Hunziker, VP of Business Development

Why another National PPO in the workers’ compensation marketplace? Good question.

Let’s ask ourselves if the current Work Comp PPO’s have lived up to their billing.  I believe the answer is no. Yes, they are good solid networks that are fully developed and in some cases they have solid discounts. Service can be ok, but not great.

Promoting a new National Network at an up and coming network development company is both scary and exciting. We’re young and aggressive. I submit that we will listen to what you have to say to us and actually do something about those providers that you’d like to have in a Network – and not 6 months from now.

Here are a few things I’d like to share with anyone who will listen about who we are at PHS and why I believe we should be a PPO solution for you today.

Why Prime? We have a “Do it now” attitude. We’ve developed a great PPO in three product lines, Group Health, Workers’ Compensation and Auto Liability that will be deployed rapidly (in some cases, just a few days) with credentialed, qualified providers where you need them. Ask us about customizing networks for panels or EPO’s for you. In cases where we don’t have provider coverage ask us what a customizing project would or could look like.

You see, we ARE in the Network Development business. Not just offering you a “fire and forget” PPO. We have creative minds at Prime Health and we’ve developed a network recruiting and contracting tool called QueBall. QueBall is an online provider nomination and contracting management web-enabled application which has saved us an estimated 30% in overall contracting time management.  Expediting provider contracting and credentialing gets providers into the Prime PPO faster and deployed to you in rapid fashion! QueBall combined with an honest, friendly recruiting and contracting team makes for a great start with any provider contract relationship. As payors, you should know that we care about our PPO provider community that we are creating at Prime Health.

Here’s what we want to bring to your attention; I’m calling it Prime Time.

T. Tenacity.

We, at Prime, will be tenacious, yet sensitive with staff, clients and resources to work to bring you a quality network offering.

I. Innovate. Create. We will keep the network development ideas flowing.

M. Prime Health will manage. We will manage our time, resources and network product to work effectively with our client partners. We will work to set proper client expectations for good product and service delivery.

E. Expect . We expect to achieve solid client relationships and long lasting partnerships in the marketplace.

I will  leave you with a quote from a book I recently read called “The Fourteen Laws of Teamwork” by John Maxwell.  It is this; “The Law of Significance. You cannot do anything of real value alone.”

Give us a call at (888) 565-9012. We’d love to talk with you about developing a PPO Network relationship with Prime Health.

bhunziker@prime-health.net

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In This Issue

The CEO Corner

This Spring Prime Health Services, inc.continues to grow into new markets with new PPO products. 

 PHS is now contracting in the international arena.  We would appreciate your time reading two articles in this newsletter that highlight our international efforts, including a newly contracted hospital system in India.  PHS also has excellent PPO coverage and negotiation ability in the Carribean and Latin America.  This is a very exciting PPO product line for Prime Health Services because we recognize that Insurance Carriers, TPAs, and Self-Insured Employers have world wide PPO discount needs, not just here in the USA.

As always, we appreciate our Payor clients and Providers.  Our goal is to provide you with excellent customer service and a quality PPO network.  If I can be of assistance to you in any way please feel free to contact me at bsharp@prime-health.net or via telephone at 615.329.4098.

www.prime-health.net

PHS Participates in Tennessee Association of Health Underwriters.

Bethany Cook, PHS Director of Business Development

Prime Health Services is an active member of the Tennessee Association of Health Underwriters (TNAHU).  On March 16^th of this year, the TNAHU held their annual group health symposium at the Cool Springs Marriott in Franklin,Tennessee.  Prime Health was a proud participant and exhibitor at this year’s symposium.  We shared the spotlight with many of the states key carriers, TPA’s and cost containment companies. 

Prime Health has worked diligently over the past few years to grow and maintain our PPO network.

We have a strong experienced contracting staff with the expertise to negotiate competitive discounts with the provider community.  Therefore, we have become one of the premier PPO’s in the United States.  If you would like more information about our Group Health network please contact me, Bethany Cook at 615-565-9014 or email bcook@prime-health.net

Please Visit www.comppayor.com for information on the Tennessee State Fee schedule.