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