- Who does PHN contract with?
PHN will contract with insurance companies, TPA's (Third Party Administrator), directly with employers or employer coalitions, and Regional PPO Networks.
- What requirements must be met in order to receive the savings available from PHN participating providers?
- A contract between payor and PHN must exist.
- Monthly Access Fee payment must be made to allow access to and maintenance of the PHN provider network.
- Benefit plans to include differentials (20% minimum) encouraging utilization of PHN providers, i.e. in-network vs. out-of-network benefit levels.
- The PHN logo must be placed on ID cards for accurate identification of patients.
- Does PHN reprice claims?
No. PHN will make a provider data file and corresponding provider reimbursements available to contracted payors to allow timely and accurate repricing.
- What are the levels of discounts available through the PHN provider network?
PHN has negotiated competitive contracts with its participating providers that result in significant and meaningful savings that meet, and in most cases exceed, its competitor's networks.
- Are provider directories available?
Maintaining accurate and timely provider directories presents an on-going challenge to any PPO. PHN has elected not to include printed directories, but do make available an electronic directory (pdf) file that allows for easy printing. The provider search component of our web site, www.preveappo.com is updated daily. PPO participants should consult their benefit plan ID card for instructions on provider verification.
- Does PHN have a toll free telephone number?
Our toll-free number: 866-640-7444
Local phone number: 920-272-1100
- Does PHN answer benefit questions?
No, that is best left to company benefit managers or to the insurance carrier or TPA that is responsible for claims payment and adjudication.
- Are sample payor contracts available for review?
Yes, contact preveappoinfo.com or call (920) 272-1100 to receive access to sample contracts.