PHCS is the leading PPO provider network and the largest in the nation. UHF has branded its health care cost sharing program Universal HealthShare (UHS). ), Privacy PolicySurprise Medical Bills Transparency in Coverage - Machine Readable Files Translation Disclaimer Sitemap, Corporate Headquarters1500 West Park Drive, Suite 330Westborough, MA 01581Directions, Phone: 508-752-2480Toll-free: 800-532-7575Fax: 508-754-9664, Health Plans, Inc. is a Harvard Pilgrim company, PHCS Practitioner & Ancillary Only Network. Summary of the Transparency in Coverage (TiC) Rule and No Surprises Act under the Consolidated Appropriations Act, 2021 (CAA), In-network rates for covered items and services, Out-of-network allowed amounts and billed charges for covered items and services, Currently the requirement for MRF Pharmacy data has been deferred. Most other eligible medical service expenses can be shared after you have paid eligible medical expenses in a cumulative amount equal to the applicable Annual Non-Sharable Amount (NSA), and after you have satisfied any applicable waiting periods. You will be redirected once the validation is complete. Preferred Health Professionals, LLC offers several different PPO networks. Provider Network of America, LLC 2023. We will ask you and each family member to complete an online Health Questionnaire to become eligible for sharing. <> Exceptions to NSA include Primary Care, Urgent Care, and Specialist Care office visits. Ancillary Services13 Multiplan/PHCS Practitioner and Ancillary Network -- Sharing of physician and ancillary service expenses is available only for In Network providers. Does PHCS cover couples therapy? <>/Font<>/ProcSet[/PDF/Text]>>/StructParents 1/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj Always confirm network participation and provide your WeShare Member ID card prior to scheduling an appointment and before services are rendered. This process is automatic. For the PHCS Network, 1-800-922-4362 For PHCS Healthy Directions, 1-800-678-7427 For the MultiPlan Network, 1-888-342-7427 For the HealthEOS Network, 1-800-279-9776 For language assistance, please call 1-866-981-7427 For TTY/TTD service, please call 1-866-918-7427 Search for a provider > I want Universal Health Fellowship to contact me, I agree with the Universal Health Fellowship. HOW DO I FIND OUT IF MY DOCTOR IS IN THE PHCS PRACTIONER ONLY NETWORK? For example, over 90% of the practitioners in the PHCS Network are contracted under a fixed fee schedule arrangement. Acadia-St. Landry Hospital. x[`WwXab6BGocfAL lHX!.(N 9`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7`g7v|u/wm]_=ojIOqFJ qos-vn:Ig442%vcv q`;s)NKM;}n,9{`Q`%)NK`%qvvcvdS>n7j'NU+e)NK+]R>n7j[`%I#&#gk-%G7\`8n7iWvvvc `WQvqH*]`8n7v[BU/nan,9NyYvvc `NyIn][K` vfnqn,`8oCX;m4nFqvv2`N}s-%^-vU~nan,`ek`4n7g~v&v2`d.];=dW. Medical services subject to meeting the NSA include inpatient, outpatient, and diagnostic services. endobj Inpatient room and board are shared up to $2,750 per day, per year for 10 days maximum (subject to the annual maximum limit of $27,500). You may receive in- and out-patient hospital-based services from any facility you prefer. To keep members sharing contributions low, UHS SmartShare offers limited sharing with fixed fee amounts. These charges are sharable when you become an eligible member and pay a consultation fee for the office visit. For more general inquiries, call 877-987-1233. Universal HealthShare members are a community of people who participate in voluntary health sharing of eligible medical expenses and accept our Statement of Shared Faith and Beliefs. Our teams of industry experts are trained to develop contracts that are mutually beneficial for the patient, the payer and the Provider. endobj Most states with an Individual Mandate have an exemption from the State Tax Penalty for members of HCSMs that meet state requirements (a State Exemption). Flexible repricing solutions that streamline claims administration and payment processing through a series of automated tools, including electronic submissions. PNOA contracts directly with our Providers to deliver competitive discounts and maximize savings for patients who utilize in-network Providers and facilities. In Network Only: PHCS/Multiplan Practitioner & Ancillary Only Provider Network Hospital4 Open Non-Sharable Amount (NSA) 8 Non-Sharable Amount Per Member (NSA)8 $1,500 $5,000 $6,000 Non-Sharable Amount (NSA) for 2 Persons8 $3,000 $10,000 $12,000 Non-Sharable Amount (NSA) for 3 or more8 How to find a PHCS Practitioner Only Network provider We can help you find the provider of your choice. Emergency Room visits are shared up to two incidents per Program Year at $100 per incident. You can use any hospital anywhere in the continental U.S.A. A PPO consists of a select network of health care providers under contract to serve member employees and their families for a reduced fee. <>stream Also, most in-patient and out-patient services (such as surgeries and hospital admissions) require pre-notification by calling customer service. Many clients prefer to see their therapists online via a secure online platform, as it makes mental health treatment convenient and more accessible. For a faster response, please call us directly at 888-666-8135. 98 0 obj <>stream The Health Questionnaire can be found in the member portal where information received is kept secure and confidential. <> PHCS, which stands for Private Healthcare Systems, is not an insurance company. PHCS Practitioner & Ancillary Only Network (Note: you may also have access to the MultiPlan Practitioner & Ancillary Only Network. Core Value Access is only available in CA in the following markets: Los Angeles, Santa Ana, San Diego, Santa Barbara, Fresno Not available in the Dallas, TX market. - With the PHCS Practitioner and Ancillary network. Gain access to our online claim entry tool. Comprehensive and high-quality provider networks. 12662043. Copyright 2019-2022 Universal Health Fellowship. Any changes made to their sharing program will typically become effective on the anniversary date. Im interested in introducing health sharing to my clients. We ask and expect that our sharing program members will adopt and live healthy lifestyles for the benefit of themselves and other sharing members, as doing so keeps medical costs lower for all. We include Teladoc services and an optional wellness program from Vitality , so you can keep your members healthy and productive. 315 0 obj endstream endobj startxref 800-482-8770; sales@optimedhealth.com; Solutions . Please consult your state tax laws to determine if you may be subject to an individual mandate. You may receive in- and out-patient hospital-based services from any facility you prefer. <> Whether a self-funded employer, TPA, insurance carrier, Taft-Hartley Trust plan, Native American Tribe or cost containment company, PNOA provides an extensive Provider Network that can produce substantial savings. fn>Cu;|=lGJ5tiBOC3Q- Kr8yl5[Xl= >>endobj Provider Network of America (PNOA) is a nationwide, direct, contracted provider network. When you have an eligible medical expense (a Medical Need), sharing funds from other members can be used to help you meet that expense. /ViewerPreferences <> hb``g``je`a` @1V a5DfNCI,DV7bYH?:yNH20T<7=_!&x -.f`o@ 6%g %%EOF All rights reserved. % Through PNOA Provider Relations and Account Management departments, roster updates and claim inquiries are handled promptly and efficiently by our professionally trained staff. *** Although not a health insurance provider, PHCS is a Preferred Provider Organization (PPO) network. We also feature significant fixed fee arrangements. The service requires full JavaScript support in order to view this website. We're currently processing your request and we'll be in touch soon. Preferred Provider Organization (PPO) is todays most widely-utilized managed health care plan. How much will I pay for Universal HealthShare? Please consult the Sharing Guidelines for details. <> 5 0 obj If you choose to leave, we ask you to give us 30-days advance notice to help accommodate other sharing members. The PHCS Network consistently achieves superior savingsincluding a Network-Based Solutions:national average savings over 40% for practitioner and ancillary facility claims. UHF will manage those contributions for you, distributing funds as needed to help other Universal HealthShare members with their eligible health care expenses, and to help cover the operational and administrative costs of UHF. PHCS Practitioner Plus Ancillary Network* Multiplan Practitioner Plus Ancillary Network* for employees of: *Please note, you may use the network search tool for professional (physicians) and ancillary (chiropractors, laboratories, physical therapists, etc) providers. Doctor.com has profiles for millions of doctors and other health providers in the United States, including those who take Multiplan PHCS insurance. More details about this are on the back of your membership card. NTWK. 71 0 obj <>/Filter/FlateDecode/ID[<45EB451CDD69B445990CC61D0CE630DC>]/Index[41 58]/Info 40 0 R/Length 135/Prev 278879/Root 42 0 R/Size 99/Type/XRef/W[1 3 1]>>stream A Medical Incident is a medically diagnosed condition and all medical treatment(s) received and medical expenses incurred relating to that condition. What is the Waiting Period for UHS SmartShare? <>/Metadata 582 0 R/ViewerPreferences 583 0 R>> Physical Address. Offered through our partnership with FlexCare, telemedicine gives you immediate access to board-certified doctors. 2 0 obj Is there a required minimum timeframe for membership? When does my sharing program membership begin? www.universalhealthfellowship.org is using a security service for protection against online attacks. Yes, except for the first year of continuous sharing, pre-existing conditions are sharable based on the waiting periods and sharing limits of the program as follows: UHS SmartShare is designed for the individual or family who wants the peace of mind of health sharing, but a more affordable monthly share amount. Click hereto learn more. While every effort is made to ensure that we provide current, accurate data, provider information changes frequently. Find information about our services. is best practice to reach out to WeShare Member Services prior to visit to ensure the provider is still in network, as this can change. The UHS Sharing Guidelines is a document provided to members to serve two main purposes: (1) it directs monthly contributions between members in its health care cost sharing ministry program, and (2) it describes the types of medical expenses the members have agreed to share among themselves. 2022 Unite Health Share Ministries and WeShare. endobj <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> website and services to function. Unite Health Share Ministries and WeShare. Always call your provider in advance to confirm that they are a current member of Multiplan/PHCS before you incur medical expenses. MultiPlan owns PHCS. endobj is a specialist that offers services and treatment options in Cardiology. Hn)9'`v" IO6}ERHQC P?<>>|<=/,_" Y!oG\q4.~S|^qydCs!Cw{w/a3ceq=!4*r/o6ww:Po9V[E\ONzlRlQ >oo_p-11[Va'"+u4+1dYw=S,]y|XKlig \u+mX64v=| |^AI^efb!~BN#L^_H 9q//dA(k0rRCV9FisE'Iu/Dl1)bsFATh-}ey\/-TmrVf] Bn& All Rights Reserved. Universal HealthShare uses the Multiplan/PHCS Practitioner & Ancillary Network with over 700,000 practitioners nationwide. %PDF-1.7 It provides networks of doctors, hospitals and medical professionals, like its parent company, MultiPlan. In todays health care environment, consumer needs are complex and continuously shifting. <> endobj Health Plans Inc. is a Harvard Pilgrim company Copyright 2023, HealthSmart Physician/Ancillary Only Network*, Multiplan Practitioner Plus Ancillary Network, Transparency in Coverage Machine Readable Files. By showing providers with higher ProfilePoints first, endstream You can speak to a telemedicine professional via a phone call, through a mobile app, or online video. [{e(p6)x8IZk(hj9+4V%YA=~R When can I begin sharing medical expenses? To look up providers within the Multiplan/PHCS network, visit this link. The sharing programs, services, publications, and any materials given should never be considered a substitute for an insurance policy. It is both a care management company and a network-based insurance company. insurance, payment options, etc. Do I have to pay for Telemedicine consultations? With UHS, there are no copayments as there are with traditional insurance products, but there are per-visit consultation fees that are not sharable. You will always remain responsible for your medical bills, and you may be treated as a cash paying patient. PNOA welcomes new health care Providers to join our community! See your Member ID card for details.) HealthSmart Physician/Ancillary Only Network* for employees of: *To search, select "HealthSmart Physician/Ancillary Only" from the network plan options.Please note, you may use the network search tool for professional (physicians) and ancillary (chiropractors, laboratories, physical therapists, etc) providers. When searching for providers, the results presented are for reference only; as participating physicians, hospitals, and/or healthcare providers may have changed since the online directory was last updated. Frances Catherine Baxley, M.D. The service requires full cookie support in order to view this website. By contracting with this network, our members benefit from pre-negotiated rates and payment processes that lead to a much smoother process and overall cost savings. by providers with Doctor.com accounts when editing their profile on Doctor.com. www.universalhealthfellowship.org is using a security service for protection against online attacks. * Network and State are mandatory and you may enter in any other search options too. Non-Sharable Amounts (NSA) 8 Per Individual Member8 Its the fastest, most convenient, and often the lowest cost way to access medical care. <> With the fourth membership year, a condition is no longer considered pre-existing. PHCS health insurance is a private health system and was recently acquired by MultiPlan. Our national network provides access to more than 2,500 hospitals, 25,000 ancillary facilities, and over 525,000 professional providers. Wide-ranging availability that meets any network needs. HealthSmart's online provider directory is provided for reference purposes only. To look up providers within the Multiplan/PHCS network, visit this link. PHCS-Practitioner-and-Ancillary-Only Appeal Rights. 9\E(\8relv6>B(/i E"|&/.Gjx$!y'tYiCR'Q1| hWmo6+b;"@ADcZ4~QkN8xGkk)'J)'/"BXH4xTAD!1ZNPPQ(ID)T:JYah0bjUIu{hW`8_NM9NOs!@4U6:/WBu^e*{y;j&eZm?>/gdrZ-7us2U{1.>W/YuV~VeQ@NwU}u,;RdofJ`\ Y,DdXozvOegN''iQ:L. If you are unsure of your plan's network, contact your employer, call HPI, orlog in to My Plan after your effective date to access your specific network search tool. xMO@0IR PreferredOne 1 0 obj Please enable JavaScript on your browser and try again. www.universalhealthfellowship.org is using a security service for protection against online attacks. What hospitals can I use with Universal HealthShare? Is MultiPlan legit? All related medical bills are treated as part of the same Medical Incident. In order to confirm the PPO network you have access to, please check for the PPO network logo on your health insurance ID card, or check with your benefit administrator. A few states have enacted an individual mandate requiring residents to have minimum essential health insurance coverage (an Individual Mandate) and imposing a financial penalty on those who have no qualified health insurance and have not qualified for an exemption (a State Tax Penalty). But many providers in the Multiplan/PHCS network may choose to accept your Universal HealthShare membership card and submit your medical expenses directly to us, minus applicable NSA and consultation fees. Members can access the Sharing Guidelines by logging into their Member Portals. 11 0 obj 1600 W Broadway Rd., STE 300, Tempe, AZ 85282, For Employers, TPAs, Insurance Carriers and Health Care Providers, Through Analytics, Cost Management and Aggressive Discounts. Schedule an appointment with Sarah Alexander at NorthShore. What is the purpose of the UHS Sharing Guidelines? Lifestyle considerations include: The date when membership in your UHS program begins is called your Effective Date. Yes, PHCS covers online therapy services. /StructTreeRoot 5 0 R To become eligible to receive sharing, every family member must complete the Health Questionnaire in the member portal. You may receive in- and out-patient hospital-based and facility services from any provider you prefer. Sarah Alexander, M.D. What makes UHS SmartShare different from the standard UHS programs? Please note, you may use the network search tool for professional (physicians) and ancillary (chiropractors, laboratories, physical therapists, etc) providers. 9 0 obj <> We also feature significant fixed fee arrangements. <> The sharing program you choose will determine your monthly sharing contribution. The PHCS Network consistently achieves superior savingsincluding a national average savings over 40% for practitioner and ancillary facility claims. WeShare, a program of Unite Health Share Ministries (UHSM), is a religious organization facilitating the sharing of medical expenses. Membership is not offered through an insurance company, and the organization is not subject to the regulatory requirements or consumer protections of any states insurance code. Is completing a health questionnaire required after enrolling in a UHS program? <> endobj hbbd```b``"A$9d 5 L.3!7`v8Z In addition to your monthly sharing contribution you will be charged a one-time non-refundable application fee of $75 and ongoing monthly membership dues, currently $15 per month, to join and remain a member of Universal Health Fellowship. For providers that do not, you can submit the itemized bill to Universal HealthShare and sharing funds will be sent directly to you. endobj endstream endobj 42 0 obj <>>> endobj 43 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/Properties<>/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 44 0 obj <>stream Each individual or family chooses the program that best fits them. But the two entities have different provider networks for their insurance company clients. stream ), Maine's Choice Plus for Services Provided in 2023, All Multiplan networks(Note: Follow the instructions on the page to select the network that appears on your Member ID card. Sharing eligibility for a members medical expenses will be determined by their Effective Date, which will also become the members anniversary date with UHF. * Plans in CO will be available for October 1, 2021, and later effective dates. ), All other PHCS networks(Note: Follow the instructions on the page to select the network that appears on your Member ID card. UHSM medical sharing eligibility extends to qualifying costs at the more than 1.2 million doctors, hospitals, and specialists in this network. How does my medical provider receive reimbursement? For UHS SmartShare, there is a 90-day waiting period before any Medical Expense Need may be eligible for sharing. How are my monthly contributions distributed for sharing? Examples include CA, MA, NJ, RI, VT, and DC.
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