MultiPlan's Provider Portal allows healthcare providers to verify network participation, submit billing and network inquiries, and more! You need to enable JavaScript to run this app. When selecting a provider, contact the providers office to verify that they are still in-network with PHCS and that the providers billing NPI# is contracted through the PHCS/Multiplan network. Did you receive an inquiry about buying MultiPlan insurance? Provider self-service portal and . Click on "Specific Services". Please press the Continue button to proceed. As an ancillary facility such as a lab, rehab or hospice. We are not an insurance company. Did you receive an inquiry about buying MultiPlan insurance? Before scheduling your appointment or receiving services from these or any providers, check with the provider to confirm their participation in the network at . #8\gBLJ>[9\G Our website uses cookies. hb`````f``g@@,)B 5W353``>zEpC!+Y7H0+6+=;&R\$,b$/#aq We're currently processing your request and we'll be in touch soon. Saint Charles, IL 60174. Bookmark it today at https://provider.multiplan.com/provider. Visit the PHCS Network homepage. 1550 Liberty Ridge Drive You will be able to search by name, specialty, facility type, National Provider Identifier Number (NPI#), or license number. For more information, visit multiplan.com. To find a participating provider outside of Oklahoma, follow the steps listed below. The PHCS Network is available in a variety of configurations including outside the plan service area, to extend local HMO or PPO coverage nationally. 516011. Beech Street Network MultiPlans regional PPO network in Alaska, Nevada and Utah. NCQA can be found online atncqa.org, on Twitter @ncqa, on Facebook atfacebook.com/NCQA.org/and on LinkedIn atlinkedin.com/company/ncqa.NCQA has reviewed and accredited Private Healthcare Systems, Inc.s. Doctor.com has profiles for millions of doctors and other health providers in the United States, including those who take Multiplan PHCS insurance. Please note that including your middle initial will help us find your information faster. MultiPlan is owned by Hellman & Friedman and other investors. Box 21747 For enrollment or program information, contact the health plan administrator or government healthcare website for your state. Our website uses cookies. We are not an insurance company. (d/b/a PHCS Network) Credentialing functions only. MultiPlan contracts with over 1.2 million healthcare providers and facilities to add value to any healthcare payors network access strategy. To do this, call 844-863-6850 or call MultiPlan at 800-922-4362. Read how a regional provider-owned health plan extended primary network access for its membership. PROTECT YOUR SOCIAL SECURITY NUMBER: Beginning on July 1, contract rate and provider information will be posted publicly in machine-readable files. By continuing to browse, you are agreeing to our use of cookies. [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.] NCQAs Healthcare Effectiveness Data and Information Set (HEDIS) is the most widely used performance measurement tool in health care. Savings have been drastic ($11 million). Our website uses cookies. 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. And our coverage continues to grow as we identify and add quality physicians in local markets. 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. Enter your email address and we will send you a link to reset your password. Thank you for your interest in joining MultiPlans provider networks (PHCS Medicaid Network or Texas True Choice Network) serving Medicaid and related government funded programs. Discover how provider partners work with Your Health Plan. So they decided to take. We believe there is no such thing as a standard cost management approach. 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. endstream endobj startxref Benefits are administered through Gravie with primary and regional leased networks through PreferredOne, Cigna, Aetna, PHCS/Multiplan, HealthEOS, and TLC Advantage. 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. 98% of participating providers are contracted directly, >100 network development professionals across the country, Are you a healthcare payor looking for more. ! %%EOF 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. Click on "PHCS". Please fill out the contact form below and we will reply as soon as possible. Register for an account For No Surprises Act First time visitor? Provider Portal . Please note: This network is available only outside of . MultiPlan is owned by Hellman & Friedman and other investors. By continuing to use this website, you consent to these cookies. Planstin Administration if your ID card displays the MultiPlan or PHCS logo. For complete details on the scope of this review, visitwww.ncqa.org. MultiPlan PHCS Locating a participating provider in the PHCS network begins with the specific network logo on the front of your medical ID card. 2. The PHCS Network, MultiPlans PPO network, is the largest independent primary PPO in the nation. As a group of 25 or more practitioners, such as an IPA or PHO. %PDF-1.6 % insurance, payment options, etc. hXmo6PH@v[l:t"\IN{H=Yok{lRp4g,Baaa(XrMQs0_ &P@;(Lj.D+X6R@q&D%`L+vWB&"-rZd"&Lb&90y6dTn" All rights reserved. MultiPlan online application request form. The PHCS Network was first certified in 2001 and has maintained NCQA certification/accreditation for ten consecutive cycles. You will be able to search by name, specialty, facility type, National Provider Identifier Number (NPI#), or license number. 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. Click Here to go to the PHCS / Multiplan Provider Search. This form is intended for: UnitedHealthCare Options PPO providers. As a group of 25 or more practitioners, such as an IPA or PHO. 2570 Foxfield, Suite 107. 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. 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) website and services to function. Did you receive an inquiry about buying MultiPlan insurance? How to Access the Provider Portal The portal is secure and completely web-based with no downloads required or software to install. If a participation for that provider should also be confirmed before obtaining services. 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. 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. Wayne, PA 19087610-321-1030 (tel)888-560-2447 (fax)info@imagine360.com. Claim Address: By showing providers with higher ProfilePoints first, 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. Enter the information for your search, then click continue to access the search results. A full breakdown of points can be seen Changes to any demographic information for providers contracted through a group must be submitted to MultiPlan on the group's CommunityCare is proudly owned by two of the regions premier health systems. 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. All rights reserved. Is there a participating hospital within 25 miles of your primary practice location? Contact us Explore more resources YOUR HEALTH PLAN Complete, customized solution A self-funded health plan solution that puts members first, provides flexibility and offers savings up to 30%. Click Here to go to the PHCS / Multiplan Provider Search. Average Overall User Rating for providers who take Multiplan PHCS: This network offers access in all states and includes more than 700,000 . 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. Did you receive an inquiry about buying MultiPlan insurance? 2023 MultiPlan Corporation. As a group of less than 25 practitioners. Please note: This network is available only outside of Oklahoma. We are not an insurance company. MultiPlan] Author: Employee . Case Study: Partnering to achieve certification, MultiPlan Awards $36,000 to Rural Hospitals. 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. Providers are encouraged to review the Prior Authorization List frequently for changes. Welcome to the MultiPlan Provider PortalThe portal lets you view and update your network-related information, manage tasks such as credentialing and track your customer service case history. This achievement confirms the quality and consistency of the service MultiPlan offers to its clients, providers and health plan participants who use the PHCS Network. We believe there is no such thing as a standard cost management approach. Other physicians and providers are available in our network. 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. 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). 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. By continuing to browse, you are agreeing to our use of cookies. . You need to enable JavaScript to run this app. 888-581-9738 www.labcorp.com ; Quest Diagnostics ; 866-697-8378 ; www.questdiagnostics.com . By continuing to browse, you are agreeing to our use of cookies. Are you a healthcare payor looking for more information on our provider networks? You can also create a general, printable directory of in-network providers near you by clicking on the Create Directory button. Imagine360 Administrators You need to enable JavaScript to run this app. By continuing to browse, you are agreeing to our use of cookies. 0 2023 MultiPlan Corporation. 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. When selecting a provider, contact the providers office to verify that they are still in-network with Connection Dental. icon/heading/resources Information for providers Who is Gravie? For a faster response, please call us directly at 888-666-8135. 92 0 obj <> endobj Dedicated network access for government programs. If you still have questions or prefer to get help directly from an agent, please submit a request. Were thrilled that for almost two decades, NCQA has endorsed the processes we use to credential providers participating in the PHCS Network. MultiPlans team of experts helps healthcare payors manage the cost of care, improve their competitiveness and inspire positive change. Well get back to you as soon as possible. A self-funded health plan solution that puts members first, provides flexibility and offers savings up to 30%. Enter the information for your search, then click continue to access the search results. All rights reserved. You will be able to search by group name, facility name, dentist name, or specialty. 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 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. By phone: call (800) 371-2507 Online: visit www.multiplan.com/sbmapreventiveservices and follow these steps: ; www.questdiagnostics.com please note: this network offers access in all States and includes more 700,000., visitwww.ncqa.org a request millions of doctors and other investors two decades, NCQA endorsed! Self-Funded health plan as an IPA or PHO standard cost management approach about buying insurance... Can also create a general, printable directory of in-network providers near you by on! 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