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PHCS Health Insurance

Dino Christoforakis
Dino Christoforakis

Editor in Chief & Licensed Insurance Agent.

PHCS Health Insurance is Private HealthCare Systems, and was recently acquired by MultiPlan. Although not a provider of health insurance, PHCS is a provider of PPO (Preferred Provider Organization) networks.

Their services are offered to health care plans, not individuals, as they do not sell insurance or offer any medical services. As part of MultiPlan, PHCS Health Insurance has over 40 million customers with approximately 65 million claims processed every year.

Read through this PHCS review, take a look at the reviews of PHCS left by customers that have plans that use the PHCS network, and then use the free tool on the side of this page to compare quotes from the top health insurance providers in your state for free!

History of MultiPlan

Since MultiPlan’s inception in 1980, as a hospital network in New York, it has acquired several networks including WPPN, forming HealthEOS, BEC Emergis Corp (which doubled its size), Northeast Healthcare Alliance, and Private Healthcare Systems, Inc. Currently it is in the process of acquiring Viant, Inc.

Viant, Inc. has a network of 600,000 providers, 5,400 hospitals, and 95,000 auxiliary facilities. Adding this to MultiPlan’s network of 625,000 providers, 5,000 hospitals, and 115,000 auxiliary facilities will once again almost double its size. Having gone national in 1989, MultiPlan is the nation’s largest PPO network. MultiPlan has also obtained Life Care Hospitals, which is a network of 20twenty hospitals that deal in concepts such as early intervention in order to provide the fastest and most effective recovery for difficult illnesses.

Accredited by the URAC, which is the American Accreditation HealthCare Commission, and the NCQA (National Committee for Quality Assurance), MultiPlan is now owned by a group of investors called The Carlyle Group.

The MultiPlan Networks

There are three main networks within MultiPlan. The primary network is the PHCS Network, which provides the lowest out of pocket expenses for its members. The PHCS Health Directions is an extended network which also provides the lowest cost and is intended to provide health care coverage for members traveling outside their service area. These networks host 550,000 providers, 4,100 hospitals, and 67,000 auxiliary facilities.

The MultiPlan Network is a complementary network for members who choose to go outside of the primary network. Although out-of-network costs will apply per the policy, providers working with the MultiPlan Network are contracted to provide services at the MultiPlan Network Discount. Over 27 million members access the MultiPlan Network of 569,000 providers, 4,500 hospitals, and 87,000 auxiliary facilities.

Wisconsin residents have access to HealthEOS by MultiPlan. This includes 20,000 providers and 160 hospitals. The HealthEOS network is accessed by 1.2 million people.

Another service provided by MultiPlan is Fee Negotiation Services. With 200 expert negotiators, participants are almost guaranteed never to pay retail price for health care services. MultiPlan has also negotiated with 65 facilities that specialize in organ transplants and stem cell transplants. The Centers of Excellence offers savings of up to 30% and includes up to 400 transplant programs. This allows participants to obtain quality specialized care when they need it instead of letting costs dictate their medical care.

MultiPlan’s Grants & Gifts

MultiPlan hosts an annual grant program called Rural Health Outreach Program. In 2009, it awarded $30,000 to ten different hospitals out of 163 applicants. States of the winning recipients are Illinois, Indiana (times two), Iowa, Kentucky, New Mexico, New York, Ohio, Tennessee, and Texas. Each winner will receive $3,000 to fund various programs such as cancer screenings and education, car seat safety inspections, dental screenings, fitness assessment, health clinics, health and wellness days, and nutrition and exercise.

The Annual Holiday Card Program is also underway for 2009. Every year MultiPlan hosts a contest for hospitals that are in the network, including PHCS, HealthEOS, and the MultiPlan Network. Holiday drawings from pediatric patients are submitted to MultiPlan and then voted on. The five entries who receive the most votes will have their drawings turned into holiday greeting cards, which are then supplied for no charge to the winning hospitals to use at their discretion, such as for sale in their gift shops or for a fund raising event.

The Purpose of a Preferred Provider Organization (PPO)

A PPO is a network that offers a large selection of health care providers while still allowing the flexibility of going outside of the network if you so choose. Although out of pocket costs are higher when you go out of the network, the option is there if you want it. HMO’s (Health Maintenance Organizations) do not have this alternative. Also, unlike in a HMO, with a PPO you do not have to choose a primary care provider and you are free to see specialists without a referral. Of course, these added benefits come at an additional cost as PPO’s are typically higher priced plans than HMO’s.

Deciding on a HMO or a PPO should not be strictly based on costs. You should consider how much involvement you want in your own health care management as a PPO is more consumer driven. Also, not only do you have more provider choices in a larger PPO network, but you also have more flexibility in changing your providers at will. However, HMO’s are regulated more closely by the government than PPO’s, and with a HMO you shouldn’t anticipate getting a bill from your provider.

With either type of network you should expect to receive quality medical care and complete access to all of your benefits as defined in your plan.

Compare PHCS Health Insurance Quotes

While it is not really possible to get PHCS health insurance quotes from PHCS or MultiPlan it is certainly possible to get quotes from insurance companies that use their networks. Make sure to get several quotes from those providers and many others that service your area before making a final decision on your health insurance provider, plan, or policy. To start shopping for your health insurance plan now, just enter your zip code into the box on the right side of the page. Get started comparing the best health insurance providers now!

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