NETWORK RELATIONS

National and Regional PPO Networks

HealthSmart owns several large PPO Networks. We recognize that our own preferred provider organizations may not meet the needs of all employers and that PPO Network flexibility is important to employers and their members. HealthSmart works with more than 90 networks throughout the country, as well as many regional and some client-specific networks, to find the network that best fits an employer's needs.
 

Out-Of-Network Negotiations

Most healthcare plans allow members the flexibility to use a provider of their own choice, even if the provider is out of the plan's network. Due to this flexibility or to circumstances beyond members’ control, there are times when high-dollar claims are out-of-network. So in addition to managing our clients’ in-network dollars, we will negotiate reductions in out-of-network expenditures.