Contracted with Over 750,000 Lives

 

By developing a multi-specialty network of credentialed providers located throughout the state of Arizona, more than 750,000 beneficiaries of the following ASPA contracted payors use IPA members for their health care services.

acpnlogo

America’s Choice Provider Network
www.acpnusa.com

America’s Choice Provider Network, LLC (ACPN) is a National Healthcare Savings Provider Network that has developed its own network and technology. ACPN is dedicated to finding solutions to assist every party in the healthcare transaction.

303 A Street, Suite 301
San Diego CA 92101
Phone: 619-255-0970
Fax: 619-243-1481

Email: support@ACPNUSA.com

aliera

Aliera Healthcare, Inc.
HealthPass USA LLC

214.215.9881 Direct
844.834.3456 Toll Free
844.457.7726 Fax

Corporate:
5901-B Peachtree Dunwoody Rd, Ste 200

Atlanta, GA 30346

www.alierahealthcare.com

ameriplan

AmeriPlan
www.ameriplanusa.com

AmeriPlan Health/Medical Plans of America is a consumer driven health care that provides you with a new source for cash pay patients. AmeriPlan Health is not insurance and Do not require submission of claim forms, referral forms, rosters, limitations, exclusions, calendar year maximums and no waiting for claim payments.

5700 Democracy Dr
Plano, TX 75024
Phone: 469-229-4500

Provider Relations
Phone: 800-256-3368

Customer Service
(Verify eligibility)
Phone: 800-472-3995

beechstreet

Beech Street
www.beechstreet.com

Beech Street is a network offering of MultiPlan, Inc. National in scope, the Beech Street Network is available for use as both a primary and a complementary PPO network, as well as for Workers’ Compensation, Medicare Advantage and consumer card programs.
Beech Street became a part of the MultiPlan family with the 2010 acquisition of Viant, Inc. During the course of 2012, the network will be integrated with MultiPlan’s national network solutions. Participating Beech Street providers, clients and their health plan members can continue to enjoy the benefits that the Beech Street Network delivers as we work to bring the best of our networks together under the MultiPlan brands.

Customer Service
Phone: 800-877-1444

bridgeway

Bridgeway Health Solutions
www.bridgewayhs.com

Bridgeway Health Solutions (Bridgeway) is a health maintenance organization that provides acute and long-term care services to people that are enrolled with Arizona Health Care Cost Containment System (AHCCCS). In addition, Bridgeway provides services to those that are enrolled in the Medicare Advantage program.

1501 W. Fountainhead Corporate Park
Suite #295
Tempe, AZ 85282

Member Services:
Acute Care Phone: 866-516-7224
Long-Term Care Phone: 866-475-3129
TDD/TTY: 877-658-0319

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CorVel
www.CorVel.com

CorVel Corporation is a national provider of industry-leading workers’ compensation solutions for employers, third party administrators, insurance companies, and government agencies seeking to control costs and promote positive outcomes. We apply technology, intelligence, and a human touch to the challenges of risk management so our clients can intervene early and often while being connected to the critical intelligence they need to proactively manage risk. With a robust technology platform at its core, our connected solution is delivered by a national team of associates who are committed to helping clients deliver programs that meet their organization’s performance goals.

Our services include claims management, a national network of preferred healthcare providers, case management, medical bill review, disability management and group health programs. Our innovative solutions combine claims management technologies with industry-leading medical cost containment services to meet our customers’ diverse needs – whether you need a comprehensive workers’ compensation program, or unbundled offerings such as bill review, case management or provider networks, CorVel is your partner of choice.

Phoenix Office
1850 N Central Ave, Ste 1200
Phoenix AZ 85004
Phone: 602-288-1838
Fax: 866-392-2919

Customer Service
Phone: 888-7-CorVel

fpn

Fortified Provider Network
www.fortifiedprovider.com

Currently, FPN contracts with physicians, hospitals, ancillary facilities, mid-level providers and other specialty healthcare providers who have the option of participating in one or more of our products (group health, workers compensation or auto liability).
FPN’s expertise comes from over 15 years of managing a preferred provider network as well as general healthcare industry experience. Our company is structured so that we are able to provide personalized, focused service for each of our providers. We are familiar with our providers and provide excellent and fast customer service.

8096 N. 85th Way
Suite #105
Scottsdale, AZ 85258

Phone 480-607-0222
Toll Free: 866-955-4FPN
Fax: (480-223-6373

General Inquiries
Email: FPN@fortifiedprovider.com

ghn

Galaxy Health Network
www.galaxyhealth.net

At Galaxy Health Network, we believe that Medical Cost Containment requires a custom approach suited to the needs of each of its clients individually – not a universal, one-size-fits-all-does-all method. Unlike many companies who claim to have national networks that are actually a conglomeration of rental agreements, Galaxy believes that it can best serve the needs of its clients by providing direct access to providers in the required service areas. As part of its core business Galaxy uses its network development expertise to provide access management for national and regional clients through customized provider recruitment initiatives in specific geographical areas where the clients’ needs are most evident.

631 106th Street
Arlington, Texas 76011

Mailing Address
P.O. Box 201425
Arlington, TX, 76006
Phone: 817-633-5822
Toll Free: 800-975-3322
Fax: 817-663-5729
Network Support
Email: networksupport@ghn-mci.com
Provider Services
Email: providers@ghn-mci.com
Claims
Email: claims@ghn-mci.com

health-net

www.healthnet.com

Health Net, Inc. is a publicly traded managed care organization that delivers managed health care services through health plans and government-sponsored managed care plans. Its mission is to help people be healthy, secure and comfortable. Health Net, through its subsidiaries, provides and administers health benefits to approximately 5.5 million individuals across the country through group, individual, Medicare (including the Medicare prescription drug benefit commonly referred to as “Part D”), Medicaid, U.S. Department of Defense, including TRICARE, and Veterans Affairs programs. Health Net’s behavioral health services subsidiary, Managed Health Network, Inc., provides behavioral health, substance abuse and employee assistance programs to approximately 4.8 million individuals, including Health Net’s own health plan members. Health Net’s subsidiaries also offer managed health care products related to prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.

1230 W. Washington Street
Suite 401,
Tempe, AZ 85281
Customer Contact Center
800-289-2818
TTD 800-977-6757
Provider Network Management
866-458-6509

TRICARE Handbook and fee schedule Links:

Manual https://www.hnfs.com/content/hnfs/home/tn/prov/res/prov_manuals.html   The TRICARE maximum allowable is based on the codes submitted and the zip code of the office where the services are rendered. The loading of Rates into Federal Registry is set and follows Medicare and usually completed by April of current year.   http://health.mil/Military-Health-Topics/Business-Support/Rates-and-Reimbursement/CMAC-Rates/Procedure-Pricing
ambetter

Quick Reference Guide – Ambetter from Health Net

Provider Forum Presentation – Ambetter from Health Net

Allwell from Health Net Logo

http://AZSPA.COM/wp-content/uploads/2017/11/Health-Net-AllWell.pdf

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Health Choice
www.healthchoiceaz.com

Health Choice Arizona is a managed care organization that provides healthcare to people in Arizona’s Medicaid Program, Arizona Health Care Cost Containment System (AHCCCS).
Health Choice provides services for members who live in the following counties: Maricopa, Pima, Yuma, La Paz, Santa Cruz, Apache, Coconino, Mohave and Navajo.

410 N. 44th Street, Ste. 900
Phoenix, AZ 85008
Phone: 480-968-6866
Toll Free: 800-322-8670
Pima County: 520-322-5784
Email: comments@healthchoiceaz.com

Health Choice Compliance Program Subcontractor Reporting Guide

AHCCCS Minimum Subcontract Provisions

 

Health Smart
www.healthsmart.com

Since its inception in 1967, HealthSmart has always strived to treat people with respect, emphasizing professionalism, teamwork and operational excellence. We are the nation’s largest independent administrator of health plans for self‐funded employers. An ongoing strategic expansion strategy has brought greater economies of scale and additional lines of business to our customers, such as student health, casualty claims and voluntary products. This past year we paid $6 billion in medical claims for more than 1.2 million customers. Our mission is improve the health of our members and lower the cost of healthcare.

humana

Humana Healthcare
www.Humana.com

Humana Inc., headquartered in Louisville, Kentucky, Is on of the nation’s largest publicly traded health benefits companies with members in all 50 states and Puerto Rico. Humana offers a diversified portfolio of health insurance products and related services – through traditional and consumer-choice plans – to employer groups, government-sponsored plans, and individuals.
Since 1961, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, provider guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.

20860 N Tatum Blvd
Suite 400
Phoenix AZ 85050
Phone: 480-515-6400
Customer Service Department
Commercial HMO and PPO
Phone: 800-448-6262
Medicare Advantage
Phone: 800-457-4708
Provider Services
Phone: 800-626-2741

E-Connectivity
Email: deployment@humana.com

ihplan

Integrated Health Plan, Inc.
www.ihplan.com

Integrated Health Plan (IHP) is one of the nation’s oldest and largest PPO networks. IHP offers its clients substantial savings on medical expenditures via use of its comprehensive credentialed provider network, claim negotiations, and medical bill audit services. IHP offers its health care providers an opportunity for increased utilization, prompt payment of claims, simplified administrative procedures and a very competitive reimbursement arrangement. IHP continues to offer its clients and providers unsurpassed, personalized customer service.

4020 Park Street North
Suite 101
St. Petersburg, Fl 33709
Phone: 727-345-8614
Toll Free: 888-640-8707
Fax: 727-3545-7680

Provider Relations
Email: info@ihplan.com

medsolutions

Med Solutions
www.MedSolutions.com

MedSolutions began in 1992 as an owner/operator of diagnostic imaging centers, but quickly saw an increasing need in the managed care industry for intensely focused radiology benefits management. In 1997, we sold our diagnostic imaging centers and MedSolutions set out to focus solely on managing the cost of imaging and helped pioneer the new industry of radiology benefits management. We soon established ourselves as the industry leader, helping healthcare payers control the soaring costs in radiology.
Today, MedSolutions has taken the clinical knowledge, proprietary technology, and forward thinking we perfected in radiology management and applied it to other areas of healthcare where we see opportunity for significant improvement, both in quality of care and in cost savings to health plans. MedSolutions continues to evolve to meet the challenges of the healthcare industry through Intelligent Cost Management, developing and introducing new services that extend beyond utilization management to capture maximum savings, reduce overall treatment costs, and ensure diagnostic accuracy.

730 Cool Springs Blvd., Suite 800
Franklin TN 37067
Phone: 800-467-6424

multiplan

Multiplan/PHCS
www.multiplan.com

Founded in 1980, MultiPlan is the industry’s most comprehensive provider of healthcare cost management solutions.
We have almost 900,000 healthcare providers under contract, an estimated 57 million consumers accessing our network products, and 110 million claims processed through our networks each year, giving us more of the experience and resources healthcare payers in the commercial healthcare, government, workers’ compensation and auto markets need to face today’s unprecedented cost and competitive pressures.
In addition to offering regional PPO networks in Wisconsin and the southwest, we’re the only company that can offer access to the leading independent national primary PPO as well as our complementary network, and negotiation and medical reimbursement services through a single electronic submission.
We have the know-how and creativity to offer more choices and more value for today’s healthcare payers and providers.

115 Fifth Avenue
New York, NY 10003
Phone: 212-780-2000
Fax: 212-780-0420

PHCS Savility, visit www.PHCSsavility.com

PHCS Network
Phone: 800-922-4362

MultiPlan Network
Phone: 888-342-7427

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Prime Healthcare
www.primehealthcare.com

Prime Healthcare Services and the non-profit Prime Healthcare Foundation employ more than 30,000 people and own and operate 28 acute care hospitals in California, Kansas, Nevada, New Jersey, Pennsylvania, Rhode Island and Texas. Prime Healthcare was recognized as a Top 15 Health System in the nation in 2013 and 2012. It also earned the distinction in 2009.

Eight Prime Healthcare Hospitals in California were recognized among the 100 Top Hospitals in the nation in 2014. Desert Valley Hospital and West Anaheim Medical Center have earned the honor five times. Centinela Hospital Medical Center, Chino Valley Medical Center, Garden Grove Community Hospital were also recognized, each for the third time, in 2014, as well as San Dimas Community Hospital and Shasta Regional Medical Center, for the second time, and La Palma Intercommunity Hospital and Paradise Valley Hospital earning their first recognition in this list.

With nearly 3,000 U.S. hospitals surveyed, the hospitals demonstrated that high-quality patient outcomes can be achieved while improving efficiency. If all hospitals in the U.S. performed at the same level as the 100 Top Hospitals award winners:
ï‚· Nearly 165,000 additional lives could be saved
ï‚· Nearly 90,000 additional patients could be complication-free
ï‚· More than $5.4 billion could be saved
ï‚· The average patient stay would decrease by half a day

In 2014, thirteen Prime Healthcare hospitals were ranked as “Top Performers on Key Quality Measures” by the Joint Commission, the leading Accreditor of healthcare organizations

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Provider Select, Inc.
www.psippo.net
Provider Select, Inc. (PSI) is a National Preferred Provider Organization that offers a full spectrum of services, ready for access with customizable solutions.
PSI has almost 500,000 providers and facilities in all 50 states and the District of Columbia forming the PSI Network ready for workers’ compensation, group health, general and auto liability claims payors nationwide. PSI offers our National Network System to the TPA, insurance carrier, and self-insured markets.
P.O. Box 330070 Fort Worth , TX 76163 Phone General Inquiries 817-426-3665

threerivers

Three Rivers Provider Network
www.trpnppo.com
Three Rivers Provider Network (TRPN) was founded in 1996 as a company that was contracted to provide services for several major auto clients. At that time, our clients needed to access a network that would grant PPO type discounts without incurring balance billing risks for their members. Over time, given superior results and the high levels of satisfaction of service that were achieved, TRPN was prompted by other companies that focused on group health and workers compensation to perform similar type services for them. TRPN contracts were uniquely designed for group health, workers compensation and auto liability claims expanding existing coverage and significantly reducing out of network expense.
Since that time, TRPN has evolved into the largest and fastest growing proprietary PPO network in the United States. The TRPN network is now comprised of more than 600,000 total providers, including greater than 5,000 hospitals and 70,000 ancillary facilities. Through our clients, approximately 10 million lives now have access to the TRPN PPO network.
Our senior management team each have an average 17 years healthcare industry experience. TRPN is committed to maintaining a quality product with superior levels of service resulting in increased choices for the member along with our clients realizing more value for their healthcare dollars spent.

910 Hale Place, Suite 101
Chula Vista, CA 91914

Tricare
https://tricare.mil/

The launch of the first phase of our https://www.tricare-west.com  website this week and the posting of their first West Region provider newsletter, a preview of the TRICARE Provider Handbook and the first of their provider quick reference charts. Sample ID cards are found in Handbook new and from handbook on www.hnfs.com .  The TRICARE West Region website went live on November 1, 2017 and also contains a review of TRICARE benefits and EFT/ERA forms to complete to ensure your entities are set up for electronic payment.

URL –   https://www.tricare-west.com/content/hnfs/home/tw/prov.html

 – Newsletter: https://www.tricare-west.com/content/hnfs/home/tw/prov/res/provider_newsletters/tricare-provider-news-2017.html#form_1509471748252

Handbook/Quick Reference Charts: https://www.tricare-west.com/content/hnfs/home/tw/prov/res/prov_manuals.htm

Providers who have questions on EFT/ERA/EDI or NPI, please call 1-855-200-0756.

EFT Form Electronic Funds Transfer Authorization Agreement

ERA Form Electronic Remittance Advice

EDI NPI Form

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usamco

USA Managed Care Organization
www.usamco.com

USA Managed Care Organization (USA) is the largest, most comprehensive, privately-held Preferred Provider Organization in America. Through esteemed panels of preferred providers, ancillary products and specialty services covering the full continuum of care, USA offers innovative alternatives to traditional group health and workers’ compensation medical benefits. With a distinct freedom of choice flexibility and a 100% user-friendly platform, USA affords sound solutions through a portfolio of integrated options that are uniquely client driven; focused on the seamless blend of quality care and cost containment.

7301 N. 16th Street, #201
Phoenix, AZ 85020

Customer Care
Phone: 800- USA-0020
Email: info@usamco.com

Client Services
Email: USAClientServiecs@usamco.com

threerivers

Three Rivers Provider Network
www.trpnppo.com
Three Rivers Provider Network (TRPN) was founded in 1996 as a company that was contracted to provide services for several major auto clients. At that time, our clients needed to access a network that would grant PPO type discounts without incurring balance billing risks for their members. Over time, given superior results and the high levels of satisfaction of service that were achieved, TRPN was prompted by other companies that focused on group health and workers compensation to perform similar type services for them. TRPN contracts were uniquely designed for group health, workers compensation and auto liability claims expanding existing coverage and significantly reducing out of network expense.
Since that time, TRPN has evolved into the largest and fastest growing proprietary PPO network in the United States. The TRPN network is now comprised of more than 600,000 total providers, including greater than 5,000 hospitals and 70,000 ancillary facilities. Through our clients, approximately 10 million lives now have access to the TRPN PPO network.
Our senior management team each have an average 17 years healthcare industry experience. TRPN is committed to maintaining a quality product with superior levels of service resulting in increased choices for the member along with our clients realizing more value for their healthcare dollars spent.

910 Hale Place, Suite 101
Chula Vista, CA 91914

zelis-logo-formerly-stratose

Zelis Healthcare formerly known as Stratose
2 Concourse Parkway, Ste 300
Atlanta, GA 30328
P: (623) 566-0491 | F: (404) 250-3970
www.zelis.com

Stratose
www.stratose.com
Since 1995, Stratose has elevated expectations in healthcare cost containment. Through a unique combination of people, proprietary technology and analytics, we’ve delivered remarkable results in claims optimization, saving clients over $10 billion since inception. We serve payors of all kinds, including insurance carriers, third-party administrators (TPAs), health maintenance organizations, stop-loss carriers, Labor/Taft-Hartley funds and health plans. We currently serve the medical, dental and workers’ compensation payor markets.