Discounts on Medical Services

Save on doctors, hospitals and ancillary services (lab tests, x-rays, etc.) offered through contracted medical PPO networks.

Each physician or medical group in the network has been fully credentialed. Fees are established according to usual and customary physician fees by region. The program provides savings to members who do not have health insurance or to members who require services that may not be covered by their health insurance.

Physician Discounts

Discounts: 20%-45% savings on routine office visits and ancillary medical services such as lab work and imaging centers.

Provider network: 525,000 healthcare professionals and over 66,000 ancillaries.

Key features:

PHCS is the largest proprietary PPO in the country with nationwide access
Live operators are available to educate members on coverage levels and identify participating network providers, specialists and hospitals - with the goal of helping minimize out-of-pocket expenses
Providers must pass strict credentialing criteria
PHCS has relationships with providers associated with the majority of specialties

When making a doctor’s appointment, you should follow these procedures:

Select a doctor from the provider list included in your member kit. You can also use the provider search link on the website or call customer service to locate a specialist in your area.

When calling to make an appointment, you should identify yourself as a member of the PHCS medical network. No further information should be needed.

When arriving at the doctor’s office, present your ID card. If the office staff has any questions about the program, please direct them to call the toll-free number on the back of the card. Do not try to explain the program yourself.

The medical network utilizes fee schedules based on CPT4 codes to determine the PPO allowable on charges from doctors, labs, and most ancillary service providers. How these codes work is described below.

Current Procedural Terminology 4 (CPT4) Codes

With a complex network of providers, there has to be a way to ensure standardization. This is done with the CPT4 code. CPT4 codes organize all of the services available for proper pricing and documentation. When a doctor files a claim, he or she must provide a CPT4 code for payment. The price that is attached to that code is known as the PPO allowable. The amount charged is all the PPO will allow a provider to collect, thus the term “PPO Allowable”.

A good example would be a member who went to see her doctor for the flu. Her visit was a standard office visit, and she is an established patient. When it came time to pay the bill, the receptionist billed a CPT4 code for which the doctor's office normally billed $50. The fee schedule rate for that particular procedure code, in that city, was $33. Therefore, the PPO Allowable was $33, and the member would only pay $33.

Many patients call the network before going to the doctor’s office in an attempt to find out what payment will be required at the end of the visit. This is very difficult (and often impossible) to determine because the network cannot predict what is wrong with the patient, how long the visit will be, or whether any tests will be required. An office visit can be coded with any of numerous office visit CPT4 codes depending on whether the patient was new or established, the length of time the doctor spent with the patient, the severity of the illness, the number of conditions treated, not to mention what tests are performed. For this reason, the network discourages members from requesting this information on doctors visits in advance.

Hospital Benefits

HealthCare Mediation has a team of very experienced medical bill negotiation professionals who have the skills and resources to significantly reduce a member's payments for medical procedures.

Discounts: 20% to 40% on a member's medical bills

Key features:

Members will receive reductions on medical bills without having an adverse effect on their credit
Members may contact HealthCare Mediation before they seek medical services, after they have been treated and have a medical bill, or if their bills have been sent to collection companies
If a savings is not received, there is no charge for the service
There are no minimum bill requirements, and a refundable deposit up to a maximum of $250 may be required
Financing is available for those who qualify

These medical benefits are available with the Total Care Plan

When ready to order, click on either
the Individual Plans menu button or one of the plan links above.
If you are an association member, click on the Group Members menu button.

For a detailed description of how discount health plans work with insurance
and other excellent consumer tips - Click S.M.A.R.T. Consumer Group

Return to Product List



			QUALITY HEALTHCARE & MORE FOR LESS We save you money on a wide variety of services

			Discounts on Medical Services Save on doctors, hospitals and ancillary services (lab tests, x-rays, etc.) offered through contracted medical PPO networks. Each physician or medical group in the network has been fully credentialed. Fees are established according to usual and customary physician fees by region. The program provides savings to members who do not have health insurance or to members who require services that may not be covered by their health insurance. Physician Discounts Discounts: 20%-45% savings on routine office visits and ancillary medical services such as lab work and imaging centers. Provider network: 525,000 healthcare professionals and over 66,000 ancillaries. Key features: PHCS is the largest proprietary PPO in the country with nationwide access Live operators are available to educate members on coverage levels and identify participating network providers, specialists and hospitals - with the goal of helping minimize out-of-pocket expenses Providers must pass strict credentialing criteria PHCS has relationships with providers associated with the majority of specialties When making a doctor’s appointment, you should follow these procedures: Select a doctor from the provider list included in your member kit. You can also use the provider search link on the website or call customer service to locate a specialist in your area. When calling to make an appointment, you should identify yourself as a member of the PHCS medical network. No further information should be needed. When arriving at the doctor’s office, present your ID card. If the office staff has any questions about the program, please direct them to call the toll-free number on the back of the card. Do not try to explain the program yourself. The medical network utilizes fee schedules based on CPT4 codes to determine the PPO allowable on charges from doctors, labs, and most ancillary service providers. How these codes work is described below. Current Procedural Terminology 4 (CPT4) Codes With a complex network of providers, there has to be a way to ensure standardization. This is done with the CPT4 code. CPT4 codes organize all of the services available for proper pricing and documentation. When a doctor files a claim, he or she must provide a CPT4 code for payment. The price that is attached to that code is known as the PPO allowable. The amount charged is all the PPO will allow a provider to collect, thus the term “PPO Allowable”. A good example would be a member who went to see her doctor for the flu. Her visit was a standard office visit, and she is an established patient. When it came time to pay the bill, the receptionist billed a CPT4 code for which the doctor's office normally billed $50. The fee schedule rate for that particular procedure code, in that city, was $33. Therefore, the PPO Allowable was $33, and the member would only pay $33. Many patients call the network before going to the doctor’s office in an attempt to find out what payment will be required at the end of the visit. This is very difficult (and often impossible) to determine because the network cannot predict what is wrong with the patient, how long the visit will be, or whether any tests will be required. An office visit can be coded with any of numerous office visit CPT4 codes depending on whether the patient was new or established, the length of time the doctor spent with the patient, the severity of the illness, the number of conditions treated, not to mention what tests are performed. For this reason, the network discourages members from requesting this information on doctors visits in advance. Hospital Benefits HealthCare Mediation has a team of very experienced medical bill negotiation professionals who have the skills and resources to significantly reduce a member's payments for medical procedures. Discounts: 20% to 40% on a member's medical bills Key features: Members will receive reductions on medical bills without having an adverse effect on their credit Members may contact HealthCare Mediation before they seek medical services, after they have been treated and have a medical bill, or if their bills have been sent to collection companies If a savings is not received, there is no charge for the service There are no minimum bill requirements, and a refundable deposit up to a maximum of $250 may be required Financing is available for those who qualify These medical benefits are available with the Total Care Plan When ready to order, click on either the Individual Plans menu button or one of the plan links above. If you are an association member, click on the Group Members menu button. For a detailed description of how discount health plans work with insurance and other excellent consumer tips - Click S.M.A.R.T. Consumer Group Return to Product List