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This Web site contains a compilation of more than a thousand consumer finance  columns written by Tony Novak from the 1980s through 2006, updated and reformatted for maximum usefulness today.  New material was added after 2010.

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PHCS PPO network discount plan

originally posted: 11/22/2006  reposted: 2/18/2011 This post has not been recently reviewed or revised by the author and may be out of date. If you notice an error or are in doubt, please send a new question by email or ask for an update. Email

Q: I want to sign up for the PPO discount plan but need to be sure my doctors are on the list. I looked each of them up on the Web site and all were listed. Before I join this plan I need to be sure because the last plan I had, my doctors were listed but when it was time to be reimbursed I was told that my doctor wasn't on the list. I don't want this to happen again so can you help?

A: uses the Private Health Care Systems PPO network, also known as "PHCS", which is the nation's largest and highest rated commercial preferred provider network. The easiest way to know if a doctor is a member for this network is simply to ask the doctor's office directly. Say "I am choosing a new health plan that offers the PHCS network. Are you a participating provider?". If so, then the bill processing will be handled through the network in the same manner as an insurance plan (even though this is not an insurance plan). Unlike an insurance plan, of course, the patient's responsibility is 100% of the price-adjusted bill. Keep in mind that a doctor or hospital may drop a network at any time but this is relatively rare for this particular network because the payment schedule for doctors is higher than some others. For more information about PHCS, see the "find a provider" list on the Web site. PCHS covers medical providers only, not the prescription drug or dental plans that use a different type of provider network.


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