In 2022, ĤƵ’s PHCS Network, the largest primary PPO in the nation, received its 11th consecutive Accreditation in Credentialing from the National Committee for Quality Assurance (NCQA), a private nonprofit organization dedicated to improving health care quality. The PHCS Network is the only national independently contracted primary PPO with NCQA accreditation, demonstrating its unique commitment to the accurate and efficient credentialing of health care professionals.

First certified in 2001, the PHCS Network underwent a rigorous review of its credentialing and recredentialing processes to maintain its NCQA Accreditation in Credentialing. The network received the maximum accreditation period of 3 years. The new accreditation is valid through July 12, 2025.

The NCQA auditor noted the network’s dedicated and knowledgeable staff, fast and easy file review, and “stellar” credentialing and recredentialing files. The auditor also praised the PHCS Network’s facility credentialing program, saying the network’s report was “the best report on initial submission this surveyor has ever seen.”

“It is through our daily commitment to detail, continuous improvement, challenging ourselves and striving to meet the highest quality standard that we are able to maintain our NCQA Accreditation,” said Derek Reis-Larson, ĤƵ’s Senior Vice President of Claims Pricing ĤƵ.

About the PHCS Network

The PHCS Network provides health plan members with seamless access to healthcare services across the country, with more than 1,000,000 participating practitioners, 4,800 acute care facilities and 92,000 ancillaries. Clients who use the network see average savings of 42% on practitioner claims, 28% on inpatient claims, 24% on outpatient claims and 46% on ancillary claims.

About NCQA

NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care, with over 60% of the US population enrolled in health plans that use the measure. NCQA can be found online at , on , on and on .

About ĤƵ

ĤƵ is committed to helping healthcare payors manage the cost of care, improve their competitiveness and inspire positive change. Leveraging sophisticated technology, data analytics and a team rich with industry experience, ĤƵ interprets customers’ needs and customizes innovative solutions that combine its payment and revenue integrity, network-based and analytics-based services. ĤƵ is a trusted partner to over 700 healthcare payors in the commercial health, government and property and casualty markets. For more information, visit .

NCQA has reviewed and accredited Private Healthcare Systems, Inc.’s. (d/b/a PHCS Network) Credentialing functions only. For complete details on the scope of this review, visit .