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- A Complete Cost Management Solution
PHCS is the national leader in health care cost management. We own and operate the largest
proprietary PPO network in the United States and are the second largest care management company.
When you use the PHCS Network in tandem with PHCS Care Management,
you tap into the power of substantial savings and coordination of care. We refer your members
to in-network providers at the point of notification, which allows you to take advantage of
significant savings through increased network utilization. Additionally, your members benefit
from having access to quality providers belonging to the largest proprietary PPO in the nation.
- Solution Oriented Products and Services
The extensive PHCS Network provides your members with unprecedented choices in
their health care providers. Nearly 450,000 providers and over 4,000 facilities participate in the
PHCS Network, and those numbers are growing daily. Since 1997, the number of
providers in our Network has increased more than 50%, and the number of facilities has
skyrocketed nearly 70%.
Our highly flexible PHCS Care Management program offers you the freedom to
choose from a menu of options that best meet your unique utilization management needs and
focus on the areas that have the greatest potential for savings. Because our Care Management
program is so adaptable, you are able to employ the program in the areas where care management
can make the greatest impact.
- Substantial Savings
All of our customers have one thing in common; they benefit from our strong relationships with
providers across the nation, which allows us to offer substantial savings. Higher quality of
care for your members - significant total cost savings for your business.
Your savings increases greatly when you use PHCS Care Management. Because the
program is so flexible, you have the freedom to apply care management in the areas where it
can make the greatest financial impact. This precise allocation of resources maximizes the
use of your health care dollars.
- Greater Control Over Predicting Health Care Costs
We negotiate fixed rates with providers and facilities in our Network so you can predict
and control health care costs. Our contractors are skilled negotiators, able to manage a
wide array of situations. They are armed with information about volume and utilization that
clearly illustrates the value of participating in the PHCS Network. By
insisting upon fixed rate agreements, we help you control costs and pass savings on to
your members.
PHCS Care Management reduces your total health care claim costs by helping to
ensure that your members are receiving appropriate care at the right times and in the right
locations. We monitor your total savings with detailed PHCS Care Management
savings reports that demonstrate the cost effectiveness of the program.
- Leading-edge Technology
At PHCS, we develop and offer leading-edge technological tools that are easy to use and
make working with us more efficient. We have developed many solutions that enhance our
Network and Care Management services including:
- PHCS Customer Access, a password-protected section of our website
developed exclusively for our customers, which gives all the information and tools
you need
- PHCS e-price, a web-based repricing tool
- PHCS DataLink, a web-based tool enabling our customers to receive
cycle data and fee schedules from the PHCS Customer Access section
of www.phcs.com
- PHCS Find a Provider, an interactive online provider directory
Detailed savings reports
PHCS Care Management is supported by sophisticated technologies that enable
us to provide highly valuable cost savings reports including utilization, top 20
diagnoses/procedures by customer, potential case management and out-of-network aggregate
savings reports.
- Superior Commitment to Customer Service
In 2002, we introduced Service Excellence, a company-wide initiative designed to help us
achieve the highest level of customer service. We are committed to providing all our
employees with the tools and information they require to respond to customer requests in
a timely manner. We continuously emphasize the importance of understanding customer needs
and being accountable for our actions. We firmly believe our focus on customer service is
unmatched in the industry and think our customers would agree.
- Recognized for Quality
PHCS is the first and only national health care cost management company to earn
four endorsements of quality from two independent, nationally recognized quality assurance
organizations; the National Committee for Quality Assurance (NCQA) and URAC. Both our
Network and Utilization Management services have been recognized for quality.
Our quality endorsements include:
- NCQA certification for Credentialing and Recredentialing
- NCQA certification for Utilization Management
- URAC accreditation for Health Network with Credentialing
- URAC accreditation for Health Utilization Management
- A Partnership Approach
At PHCS, we take a partnership approach to customer relationships and recognize that each of
our customers has their own unique needs, which we are committed to meet. We have a diverse
customer base of nearly 200 unique payors, including HMOs, insurance companies, third-party
administrators, Taft-Hartley Funds, municipalities and large employers.
- Easy to Work With
Our customers find it easy and convenient to work with us. We assign an implementation team
to train our customers on our systems, help you acclimate to working with us and assist in
transitioning your members to our Network. We also assign a dedicated account manager so
you have one point of contact for working with us, no matter what your need is.
- A Strong National and Local Presence
With regional offices located across the United States, PHCS has a strong national and local
presence. Our contractors are involved in their local communities so that they understand the
market dynamics impacting health care access and affordability. They have first-hand knowledge
of which medical facilities are most important in their regions and are committed to ensure
these facilities are part of our Network. This local knowledge and connection, combined with
the bargaining strength of our large and influential customer base, offer you unparalleled
access and buying power throughout the nation.
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