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Prospective & Enrolled Members: 800-405-9681 (TTY 711) | Provider Inquiries: 1-855-969-5907 (TTY 711)

As an HMO I-SNP, Provider Partners Health Plans contracts with a network of high-quality healthcare providers in selected Illinois, Maryland, Missouri, North Carolina, Pennsylvania, and Texas counties. Provider Partners offers participating providers the following advantages:

  • Be part of a highly motivated, patient-centered team that cares about providing high-quality care to our patients and that values keeping patients healthy through advanced electronic health record systems, shared protocols, care plans and care management.
  • Reimbursement based on Medicare
  • Work with local, hands-on leadership that understands the challenges and rewards of being a provider because we are providers ourselves.

Provider Partners Health Plans provides a host of advantages to its hospital partners, including:

  • Shorter lengths of stay
  • Reduction of potentially avoidable utilization for PQI diagnoses
  • Lower 30-day readmission rates
  • Communication from a local provider clinical team to keep you informed and provide coordinated care to patients
  • Prompt and accurate claims payment

Provider Partners Health Plans offers many advantages for participating physicians, including:

  • A source of additional patients
  • A local provider clinical team that provides case management and care coordination in consultation with you
  • A provider-friendly pre-authorization process in which the long-term care facility obtains authorizations
  • Better quality of care and health outcomes for patients as measured by HEDIS scores and hospital use rates

Are you interested in joining our Provider Network?

Page Last Updated: 9/6/2023

Provider Partner Health Plans are HMO-SNPs with Medicare contracts. Enrollment in Provider Partner Health Plans depends on contract renewal. Y0135_PPHPWEB_2024