Based on the disclosures required of group health plans and health insurance issuers in the No Surprises Act, Prime Health will provide the in-network providers’ negotiated rates.
Providing these deliverables allows transparency within tasks being asked of our clients and our clients’ clients.
At Prime Health, our provider contracts are evergreen and we can track when a provider (NPI) status is disabled or a contract (TIN) is termed. We also track dates on contracts and discounts when they are added/changed.
Prime Health uses commercially reasonable efforts to maintain accurate provider directories, which are regularly updated and verified at least every 90 days. Prime Health will respond, within one business day, to individuals who inquire about the network status of a provider or facility.
To aid in this initiative, with the use of technology, Prime Health is working with industry leaders in the provider data collection and verification space.