Please see some responses below to my question:
I am wondering if anyone works with Prime Health Services PPO Network (out
of TN) as a TPA for worker’s compensation, group health, and auto? If yes,
would you recommend them and do you feel you’ve had a good experience with
them?
Responses:
1) We have a contract with them and we have no complaints.
2) After looking over their contract my advice would be run away as
fast as you can.
3) Absolutely no.
a. Reimbursement is below Medicare;
b. Work comp reimburses at 5% above Medicare;
c. Auto reimbursement is UNC or very close-several procedures auto
reduces payment amount to below UNC BUT significantly higher than Medicare
d. There is no good enough reason for anyone to accept payment levels
below Medicare.
Christie Sydow
Active Brace and Limb
