Providers
About Our Provider Network
Looking for something more?
Prime Health Services specializes in quality PPO development and supports a nationwide provider network designed for clarity, customization, and access.
A provider network built beyond “dots on the map”
While providers are located in all 50 states, the focus is on developing networks that meet each client’s specific needs, not offering a one-size-fits-all solution.
Clear contracting and customized participation
Effective contracting helps providers clearly understand which market segments they are agreeing to serve, reducing confusion and making participation more straightforward.
Quality-focused provider selection
Providers in the Prime Health Services Network are selected with an emphasis on quality of care and strategic access for the populations served.
- Workers’ Compensation
- Group Health
- Corrections
- Medicare
- Auto Liability
Take a Look at What We Offer
At Prime Health Services, we develop one of the largest directly contracted PPO networks in the country and continue expanding partnerships with high-quality medical providers. By joining the network, providers gain access to opportunities across multiple markets with the support of a company focused on provider success.
Workers’ Compensation PPO
Connect with patients who require specialized care related to work injuries through a network built around providers who understand workers’ comp treatment needs and payment structures.
Group Health PPO
Support employers, insurance plans, and other stakeholders through a broad PPO offering that helps providers reach additional patient volume and access new market opportunities.
Auto PPO
Care for patients with motor vehicle accident-related injuries through a network used by insurers seeking specialized, coordinated emergency and follow-up care.
Why Join Us?
By joining Prime, providers gain access to opportunities across multiple markets, broader visibility through one network relationship, simplified contracting and administration, and a direct path to onboarding through the contracting team.
We understand Prime may not be the right fit for every provider. That is why our team works closely with providers to ensure participation terms are clear, reasonable, and aligned for all parties whenever possible.
What providers gain
- Broad Market Access: Tap into multiple market segments with a steady referral pipeline.
- Customized Opportunities: Work with patients whose needs align with your expertise.
- Ongoing Support: Benefit from a streamlined contracting process and efficient communication.
Expand Your Patient Reach
Prime Health’s PPO network serves a broad range of clients, creating more opportunities for providers to grow their patient base while partnering with a team focused on personalized service, transparency, and long-term provider success.
A broad client base across key markets
Prime Health’s PPO network supports clients across numerous industries, helping providers access opportunities beyond a single channel and broaden their practice reach.
Privately owned, responsive, and provider-focused
As a privately owned company, Prime Health prioritizes personalized service and prompt attention for provider partners, creating a more responsive experience than a rigid, pre-set participation model.
Transparent partnerships built around clarity
Providers are supported with a clearer understanding of the services they are agreeing to deliver, helping foster transparent, effective relationships and better alignment between providers, clients, and member populations.
Claim Dispute Resolution
Prime Health Services has a dedicated repricing and reconsideration department that works on behalf of providers, cooperating partner networks, and clients to help resolve claim disputes more efficiently.
Support designed to protect provider relationships
Prime Health Services has a dedicated repricing and reconsideration department that works on behalf of providers, cooperating partner networks, and clients to help resolve claim disputes.
Industry-leading real-time bill repricing
Prime’s advanced EDI platform is designed to save time and money while supporting faster claim processing and payment visibility for providers. Prime’s model is aligned with provider outcomes because provider payment remains central to the process.
Operational highlight
Average of 14 Days
- Built to support real-time bill repricing and faster operational response.
- Clients may be contracted for clean claims within 30 days, while Prime cites average processing and payment within 14 days.
- Prime emphasizes that it is not paid until providers are paid, reinforcing aligned financial interest.
In-house credentialing and re-credentialing
Provider contracting, credentialing, and re-credentialing are handled in-house to maintain quality and consistency, while delegated credentialing remains available for organizations already credentialing to recognized standards.
Quality focus
In-House Oversight
- Supports quality control across provider contracting and credentialing workflows.
- Delegated credentialing is available for organizations aligned to standards such as URAC, NCQA, and JCAHO.
- Designed to reduce provider administrative burden and save time in a traditionally tedious process.
Customization backed by measurable network visibility
Prime tracks contract progress and compares previous versus current patient volume to help demonstrate patient growth, client origin, and additional revenue tied to provider affiliation within the network.
Visibility benefit
Track Progress + Revenue
- Compares historical and current patient quantity to show change over time.
- Helps surface client origin and additional revenue resulting from network participation.
- Supports a more customized, data-aware provider relationship.
Referral management with built-in provider promotion
Clients have access to Prime’s provider nomination tool, QueBall, making provider submissions easier while Prime also promotes providers through its website, social channels, provider directory, newsletter, and conferences.
Access point
QueBall Nominations
- Gives clients a direct way to nominate providers at the click of a button.
- Supports exposure to clients, case managers, patients, and other relevant audiences.
- Extends provider visibility across multiple owned and event-based marketing channels.
Dedicated provider relations support
Prime highlights low dispute volume, strong provider retention, and a provider relations team committed to resolving issues quickly, helping protect long-term provider satisfaction.
Relationship metrics
Less Than 1% Disputes
- Provider disputes average less than 1 percent nationally.
- Provider retention is cited at over 99 percent.
- Issues are positioned to be resolved within one business day through a dedicated provider relations team.