Providers
About Our Provider Network
Looking For Something More?
Prime Health Services specializes in quality PPO development and is uniquely positioned to offer the largest directly contracted network of medical providers available. Our preferred provider network serves the Workers’ Compensation, Group Health, Corrections (indigent care), Medicare, Auto Liability, and Personal Injury markets.
Looking for a preferred provider network that is more than just “dots on the map”? Network development is our focus and passion. While we do have providers located in all 50 states, our focus is on developing provider networks that meet the specific needs of our individual clients.
This is accomplished through customization and effective contracting, ensuring that providers clearly understand which market segments they are contractually agreeing to serve. Our network of providers is hand-selected based on their quality of care and strategic location.
As a provider in the Prime Health Services Network, you will help assure that the best care is provided—yours!
Take a Look at What We Offer
At Prime Health Services, we specialize in developing one of the largest directly contracted PPO networks in the country, and we’re always looking to expand our partnerships with high-quality medical providers. By joining our network, you’ll gain access to opportunities across multiple markets and have the support of a company focused on provider success.
Workers’ Compensation PPO
Our workers’ compensation PPO connects providers with patients who require specialized care due to work-related injuries. We work with strategically selected providers who understand the unique treatment needs and payment structures within workers’ comp cases.
Group Health PPO
Our group health PPO provides a diverse range of services to employers, insurance plans, and other stakeholders. Providers in this network benefit from expanded patient volume and access to new markets, including workers’ compensation, commercial group health, corrections (indigent care), Medicare, auto liability, and personal injury.
Auto PPO
Providers in our auto PPO care for patients with motor vehicle accident-related injuries. Leading auto insurers look to our network for specialized care, ensuring that both emergency and follow-up services are seamlessly coordinated. Being part of this network allows providers to help patients achieve better outcomes and recovery.
Why Join Us?
We offer:
Broad Market Access: Tap into various market segments with a steady referral pipeline.
Customized Opportunities: Work with patients whose needs align with your expertise.
Ongoing Support: Our team streamlines the process, ensuring ease of contracting and efficient communication
Expand Your Patient Reach
Prime Health’s PPO network serves a wide array of clients, including insurance carriers, third-party administrators (TPAs), self-insured organizations, government entities, and captive insurance groups. Our extensive client base spans numerous industries, providing opportunities to expand your patient scope.
As a privately-owned company, we prioritize personalized service and prompt attention to our provider partners. We are one of the fastest-growing preferred provider networks in the country, driven by a core philosophy of offering our clients access to providers of their choice, not restricting them to a pre-set list.
We ensure that each provider understands the services they are agreeing to deliver, fostering a transparent and effective partnership. This approach helps us better serve our clients and their employees or members with quality, customized care solutions.
Partner with us to broaden your reach and enhance your practice’s impact!
Claim Dispute Resolution
Prime Health Services has a dedicated repricing and reconsideration department that works on behalf of our providers, with cooperating partner networks and clients to resolve claim disputes.
Please note that Prime Health is unable to address questions regarding the application of bill review or state-mandated fee schedule reductions. These questions should be directed to the insurance carrier and/or bill review vendor listed on your explanation of benefits/review.
Industry leading real-time bill re-pricing. We save you both time and money. Although our clients are under contract to pay clean claims within 30 days, claims are processed and paid within an average of 14 days because of the advanced EDI platform we built. We have a stake in ensuring Prime Providers benefit from our agreement financially and are paid in a timely manner; we are not paid until our providers are paid.
All provider contracting, credentialing, and re-credentialing is handled in-house, delivering a level of unrivaled quality. Delegated credentialing is available if your organization already credentials your providers in adherence to a recognized standard such as URAC, NCQA, JCAHO, etc., saving you time in the often-tedious process of credentialing.
We have the capability to track the progress of our contracts, comparing previous versus current patient quantity to show periodically the patient increase, client origin, and the additional revenue resulting from their affiliation with our network.
Clients have online access to our provider nomination tool, QueBall, which allows them to submit their provider nominations at the click of a button. The marketing we perform on behalf of our providers is pinpointed to the clients, case managers, patients, etc. that will actually be seeing you. Our website, social media pages, the provider directory, newsletter, and conferences are examples of how we continuously promote our network of providers to our client community.
Provider disputes average less than 1% nationally and provider retention is over 99%. In large part, this is because of our contracting methodology and commitment to resolving provider issues within one business day. We also have a Provider Relations team that is dedicated to you.
