GROUP LIMITED HEALTHCARE
   DISCOUNT HEALTH CARE PRODUCTS
 
Private Health Care Systems (PHCS) Find a Provider

Provider Network: Over 525,000 healthcare professionals, and over 66,000 ancillaries
Discount Range: 20% to 45% savings

 

Careington International brings a significant competitive advantage to clients through the personalized, concierge service with which they administer their physician discount program.

Members of Careington's Physician discount program receive an identification card and "Dear Doctor" letter in their fulfillment kit with instructions to call Careington's Physician Relations Department where a live operator will provide them with a list of providers, verify participation of those providers, and schedule an appointment for the member.

The Careington PRS will also instruct the provider to contact Careington at the time of checkout and give the CPT codes for the services rendered. Careington will then communicate to the provider the PHCS allowable amount and instruct the provider to collect this entire amount. This may be done via phone, fax, email, or regular mail. The live operator feature with the PHCS option ensures that the member's experience is a positive one with very little room for error or confusion on either the member's or the doctor's part at the time of service.

With other partners who provide physician discounts, it is the member's responsibility to make an appointment with a participating physician and identify himself as a member by showing his card at the time of service. The physician will call the phone number on the card to access the call center with repricing information. Potential drawbacks to this plan lie in the fact that the member doesn't have a live Careington operator to help ensure that the doctor is participating and understands how to process the discounts, or is aware of how the plan works, and will charge correctly. Instead, he makes his own appointment, and if he doesn't have his card, the doctor will not be able to give him his discounts.

PHCS is the first and only national PPO to earn four endorsements of quality from two independent, nationally recognized quality assurance organizations, the National Committee for Quality Assurance (NCQA) and URAC.
NCQA certification for Credentialing and Re-credentialing (August 2001)
NCQA certification for Utilization Management (May 2001)
URAC accreditation for Health Network with Credentialing (October 2001)
URAC accreditation for Health Utilization Management (July 1993)
Key Features of PHCS:
PHCS is the largest proprietary PPO in the country with nationwide access
The live-operator feature ensures a positive member/provider experience
Providers must pass strict credentialing criteria
PHCS has relationships with providers associated with the majority of specialties

Note : Physician's Assistants (PA's) are not included in the PHCS network.