PHCS Network Brings Stability and Flexibility to an Evolving Market

What is the PHCS Network? 

Claritev’s PHCS Network is the largest independent, nationwide primary preferred provider organization (PPO). It is the preferred choice for health plans wanting a provider network with flexibility to meet their unique needs. Plans get administrative ease without sacrificing provider access, savings, and quality for health plan members. 

Benefits of the PHCS Network  

Provider Access and Savings 

The PHCS Network includes more than one million health care providers nationwide: 920,000 practitioners, 4,800 acute care hospitals and 87,000 ancillary facilities. Average savings by claim type are 42% for practitioner, 28% for inpatient, 24% for outpatient and 46% for ancillary facilities. 

Exceptional Quality 

With the PHCS Network, pre-Payment Integrity services are embedded in the network to correct improper billing early in the process. What’s more, the PHCS Network is the only nationwide, independent PPO to be accredited for credentialing by NCQA. Accreditation involves rigorous reviews of our provider credentialing and recredentialing policies and procedures. Provider credentialing is a key component of ensuring the network is made up of exceptional health care providers. The PHCS Network has maintained its accredited status since 2001. 

Flexibility and Administrative Ease 

Health plans can customize the PHCS Network in almost any way needed, accessing nationwide or carving out specific geographies, excluding or including only specific provider types/specialties, as the primary PPO or to extend the service area of another network, with or without tiered in-network benefits. The PHCS Network can be used by itself or as part of a total solution that helps plans manage the cost of care with only one claim submission. 

PHCS Network re-invented for strategies that include Reference-Based Pricing (RBP) 

Claritev now offers a version of the PHCS Network that is tailored specifically for use with RBP services. The PHCS Network for Value-Driven Health Plans includes practitioners and ancillary services and is available exclusively when paired with HST’s RBP service for hospitals. Healthcare systems appreciate the administrative ease of dealing with one company offering a unified network + RBP services, and health plan members appreciate the practicality and simplification of using one app or website to find care. 

To learn more, contact us.