ĤƵ

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ĤƵ’s Network-Based ĤƵ

Flexible healthcare provider networks for payors

Our healthcare provider networks at-a-glance

Types of networks

Available for commercial, Medicare Advantage, and Property and Casualty healthcare payors

Customizable

Innovative contracts add value for all types of health plans

  • Extended access for members who travel or live away
  • Blended access to fill gaps in a plan’s own network
  • Subset networks for unique plan designs
  • Custom network builds for specific populations

Quality and service

Over 40 years of experience

  • NCQA-Nationally NCQA-Nationally accredited primary PPO (PHCS Network), all others use the nationally recognized standards
  • Network contracting strategies guided by data analytics
  • Pre-payment integrity services are embedded in our networks to correct improper billing
  • 98% of participating providers are contracted directly
  • >100 network development professionals across the country
Hospital exterior with sign stating "General Hospital West Campus"

Our healthcare provider networks in action

Networks are becoming narrower and more value-based, but consumers and regulators continue to demand access to in-network providers wherever and whenever care is sought. ĤƵ contracts with over 1.2 million healthcare providers and facilities to add value to any healthcare payor’s network access strategy. Read how a regional provider-owned health plan extended primary network access for its membership.

By the numbers

person in hospital bed

5,600 hospitals

hospital

164,000 ancillaries

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1,300,000 providers and facilities

Accredited NCQA Credentialing/recredentialing since August 2001NCQA accredited symbol

The PHCS Network: a national NCQA-accredited network

ĤƵ’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. The PHCS Network is available in a variety of configurations including outside the plan service area, to extend local HMO or PPO coverage nationally.

NCQA has reviewed and Accredited the PHCS Network’s Credentialing functions only. For complete details on the scope of this review, visit

Ensuring provider data quality

stethoscope

Provider self-service

Encouraging routine updates to ensure data quality

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Predictive data cleansing

Through sophisticated data mining

headset

On shore outbound call center

Staffed by full-time employees

Male nurse pushing elderly male patient in wheelchair in busy hospital hallway

Get in touch

Are you a healthcare payor looking for more information on our provider networks?