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When looking for health insurance it is very important to keep in mind that there are many companies out there that will try offering you the best prices for your needs. However, not all of them are known all around the United States and not all of them offer you the same benefits. One of the many companies offering coverage in the continental United States is Private Health Care Systems best known as PHCS. They are the primary national PPO network and care management product of the company MultiPlan.
Before talking about PHSC it’s important to know a little bit more about the parent company. MultiPlan was founded in 1970 and is the oldest and largest of independent, network-based cost management solutions. They have more than half a million health care providers that service an estimated 40 million consumers. To top it all of the estimated millions of consumers have about 70 million claims that are processed through MultiPlan’s networks each year. How about that for a health insurance option?
On the other hand Private Health Care Systems (Owned by MultiPlan as said before) has the largest proprietary preferred provider (PPO) organization in all the United States. With about 450,000 members attending one of the 4,000 facilities PHCS members have access to a variety of providers around the United States. They are also the first and only propriety network to earn five endorsements due to quality from two nationally recognized quality assurance organizations, URAC and the National Committee for Quality Assurance (NCQA).
PHCS’ job is to contact their providers in order for them to allow their network member to visit them at lower costs. The network also has something referred to as a “High network retention rate” which means that once a customer selects a Primary Care Physician (PCP) that doctor will remain available all through their health plan. Most of the people that are members of this great network include large employers such as companies and enterprises, commercial insurance carriers, regional managed cared organizations and third party administrators. The PHCS network offers the following to its members:
National Access with Excellent Cost Savings: No matter where the members are, they offer a variety of services from coast to coast. You can contact them at (866) 750-7427 to see how much they can save you in health care costs.
PHCS Healthy Directions: Eliminates the need of having an HMO, PPO or POS because it pays full charges for services when a member travels or goes to school outside the coverage area. As a member you will be able to have freedom in order for you to choose a provider from within the national network, to lower your out of pocket costs for members with providers in the PHCS Network, and to call a toll free number in your I.D. card for provider information.
Quality: PHCS didn’t just link a variety of little networks and pierce them together, instead they created a national network that allows them to credential and re-credential their providers to maintain good quality healthcare.
Private Health Care Systems is a care management company as well as network based insurance. PHCS is the second largest independent care management company functioning in the United States today. Their care management specialists review any patients’ cases to make certain that patients receive the best treatment available as well as giving them freedom to from a variety of options that nest suit their unique utilization review needs. You are able to employ this care management system in the area of your business where it will make the biggest impact. PHCS Core Plan includes the following utilization management products, however, is important to keep in mind that you can add some supplemental products that will be discussed below in addition to the Core Value ones.
Core Value Plan:
1. Concurrent Review
3. Discharge Planning
Additional Supplemental Modules that can be purchased:
1. Chiropractic Review
2. Selective CT/MRI Review
3. Podiatry Review
4. Outpatient Rehabilitation Review
By James J. Robinson