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PHA Network Services

PHA has developed a variety of products and services to allow its clients to achieve maximum efficiency in the administration of their health plan benefits. PHA products are always custom-designed for each client thereby ensuring superior flexibility and account service.

PHA Preferred

Founded in 1986, PHA Preferred is one of California’s largest and most cost efficient preferred provider networks. Comprised of nearly 400 hospitals and 50,000 physicians and other healthcare providers, in California PHA Preferred offers standard and custom-designed networks. PHA offers clients nationwide access to over 3700 hospitals and 400,000 physicians. The wide-choice of healthcare providers gives PHA enrollee’s high quality healthcare at home or on the road. This access also simplifies health benefits administration for employers and third-party administrators. The PHA network can handle all of your local, regional and national healthcare needs.

PHA WorkNet

PHA offers an all-inclusive worker’s compensation program designed to reduce medical claim costs. Included are services to achieve positive patient outcomes, reduce lost work time and manage disability costs.

The program incorporates one of the State of California’s largest provider networks carefully constructed to include a full spectrum of cost efficient healthcare providers. The network providers have agreed to significant discounts from the established State of California Worker’s Compensation Fee Schedule.

The network is available to insurance companies, third-party administrators and self funded employers. Coupled with effective case management, the network significantly decreases healthcare costs.

Specialty PPO and Custom Network

PHA has developed chiropractic and behavioral health and centers of excellence networks to augment its group health and worker’s compensation networks. PHA also offers “custom networks” which are designed for an individual client. These request-specific networks allow PHA to customize any one of our networks. Nearly all of the PHA clients utilize a “client-specific” version of our larger networks. This allows the client to carefully match the needs of its enrollees with the most efficient providers for even greater savings. Examples of this customization include Exclusive Provider Organizations (EPO’s) multiple tiered benefit structures and proficiency-based networks.

PHA Preferred Choice

PHA Preferred Choice is a unique program designed for self-funded employers, Taft-Hartley funds, insurance companies and independent practice associations. PHA Preferred Choice provides expanded choice of healthcare providers with added savings without the necessity of changing their existing preferred provider organization.

PHA Preferred Choice automatically adds a second network to your current preferred provider program. Through our close working relationship with your group, PHA can carefully craft a complimentary provider network that will bring increased provider choice to your beneficiaries, and greatly reduce expensive out-of-network services. The result is more satisfaction among beneficiaries and greater savings to the plan.

Best yet- The only cost to you is when you save on a claim. You only pay when savings are produced. There are no access fees and no hidden costs.

PHA Claim Administration

PHA offers a full service claims administration program to provide support to a wide-range of fully-insured and self-funded employers and groups. PHA is licensed as a third party administrator in California.

PHA provides the full range of TPA services. Included are:

  • Medical Claim Administration
  • Dental Claim Administration
  • Vision Claim Administration
  • COBRA Administration
  • Stop-loss/reinsurance services
  • Recovery Services
  • Claim consulting and review
  • Case Management

The PHA claims system provides sophisticated, flexible claim administration. It is fully-integrated with our utilization management program and provider network to provide powerful core functionality. The integration provides for the ability to provide custom reports for all clients.

The PHA claims program is ideally suited to work in concert with any third-party administrator to provide any client unparalleled service.

 
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