PHCS Insurance Reviews 2023: Is It Legit Or A Scam?

If you are seeking a good health insurance scheme, then try out PHCS health insurance. To use PHCS, it is essential to remember that many companies are trying to offer you the best prices for your needs. However, not all are known in the United States and offer the same benefits.

One of the many companies offering insurance coverage in the continental United States is Private Health Care Systems, better known as PHCS. They are the most important national PPO network and maintenance management product from MultiPlan.

Before discussing PHCS health insurance, it is vital to know more about the parent company MultiPlan.

About MultiPlan

MultiPlan was founded in 1970 and is the oldest and largest independent, network-based expense management solution. More than half a million healthcare providers serve an estimated 40 million consumers.

Private Health Care Systems, owned by MultiPlan, has the most extensive proprietary Preferred Provider (PPO) organization in the entire United States.

With approximately 450,000 members attending any of the 4,000 facilities, PHCS members have access to various providers across the United States.

They are also the first and only proprietary network to have received five recognitions for quality from two nationally recognized quality assurance organizations, URAC and the National Committee for Quality Assurance (NCQA).

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What Is PHCS Health Insurance

PHCS health insurance is a private health system and was recently acquired by MultiPlan. PHCS is a Preferred Provider Organization (PPO) network.

It is both a care management company and a network-based insurance company. PHCS is now the second-largest independent care management company in the United States.

Their care management specialists review all cases to ensure patients receive the best treatment available, giving them the freedom from various options that best suit their usage review needs.

Their services are offered to health insurers, not individuals, as they do not sell insurance or provide medical services.

As part of MultiPlan, PHCS health insurance has over 40 million customers, with around 65 million claims processed yearly.

The job of PHCS is to contact their providers so that they can offer their network members a cheaper visit.

The network also has something called a “high network retention rate” which means that once a customer has selected a family doctor (PCP), that doctor will remain available throughout their health plan.

Most of the members of this great network are large employers such as corporations and corporations, commercial insurance carriers, regional managed care organizations, and outside administrators. The PHCS network offers its members the following:

1. MultiPlan History

Since MultiPlan was founded as a hospital network in New York in 1980, it has acquired multiple networks, including WPPN, HealthEOS, BEC Emergis Corp (which doubled in size), Northeast Healthcare Alliance, and Private Healthcare Systems, Inc. on the acquisition of Viant, Inc.

Viant, Inc. has a network of 600,000 providers, 5,400 hospitals, and 95,000 support agencies. Together with a network of 625,000 providers, 5,000 hospitals, and 115,000 ancillary facilities, MultiPlan will double its size again.

MultiPlan has been the country’s largest PPO network since 1989. MultiPlan has also won LifeCare Hospitals, a network of 20 twenty hospitals that deal with concepts such as early intervention to enable the fastest and most effective recovery from complex illnesses.

Accredited by URAC, the American Accreditation HealthCare Commission, and the National Committee for Quality Assurance (NCQA), MultiPlan is now owned by a group of investors called The Carlyle Group.

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2. MultiPlan Networks

The MultiPlan network is a complementary network for members who leave the primary network. Although network-independent costs are incurred according to the guideline, providers who work with the MultiPlan network are contractually obliged to provide services at a MultiPlan network discount.

There are three main networks within MultiPlan. The primary network is the PHCS network which offers the lowest outlay to its members.

The PHCS Health Directions is an expanded, lowest-cost network designed to provide medical care to members traveling outside of their coverage area.

These networks house 550,000 providers, 4,100 hospitals, and 67,000 support facilities.

Over 27 million members access the MultiPlan network of 569,000 providers, 4,500 hospitals, and 87,000 auxiliary facilities.

Another service from MultiPlan is the fee negotiation service. With 200 skilled negotiators, it is almost guaranteed that participants will never pay the retail price for healthcare services.

MultiPlan has also negotiated with 65 organizations specializing in organ transplants and stem cell transplants. The competence centers offer up to 30% savings and include 400 transplant programs.

This enables participants to receive high-quality, specialized care when needed rather than letting costs dictate their medical care.

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3. MultiPlan Grants and Gifts

MultiPlan runs an annual scholarship program called the Rural Health Outreach Program. In 2009, she awarded $ 30,000 to ten different hospitals out of 163 applicants. Winner states are Illinois, Indiana (by two), Iowa, Kentucky, New Mexico, New York, Ohio, Tennessee, and Texas.

Each winner will receive $ 3,000 to fund various programs such as cancer screening and education, car seat safety reviews, dental exams, fitness assessments, health clinics, health and wellness days, and diet and exercise.

What Is A Preferred Provider Organization? (PPO)

A PPO is a network that offers a wide variety of healthcare providers yet allows the flexibility to leave the network if you choose. Although the expenses are higher when you get off the network, the option is there if you want it.

HMOs (Health Maintenance Organizations) do not have this alternative. In contrast to an HMO, with a PPO you do not have to choose a family doctor and can visit specialists without a referral.

Of course, these benefits come with additional costs, as PPOs are typically more expensive plans than HMOs.

The decision for an HMO or a PPO should not be made strictly based on costs. It would help to consider how much involvement you want in your health management as a PPO is more consumer-centric.

In addition, in a more extensive PPO network, you have more choices of providers and more flexibility in switching providers as you wish.

However, HMOs are more government-regulated than PPOs, and with an HMO, you shouldn’t expect to receive a bill from your provider.

With either type of network, you should expect quality medical care and full access to your services as defined in your plan.

READ ALSO: EPO vs PPO Health Insurance: Which one is better?

Why PHCS Health Insurance?

Here are a few reasons why you should opt for PHCS Health Insurance:

1. PHCS Healthy Directions

This eliminates the need for an HMO, PPO, or POS, as the full fees for services are paid when a member travels outside the coverage area or goes to school.

As a member, you can choose a provider within the national network, reduce your expenses for members with providers in the PHCS network and call a toll-free number in your ID card for provider information.

2. Significant Access and Savings

With the PHCS network in your expense management strategy, you give your health plan members a choice of 4,400 hospitals, 79,000 additional care facilities, and more than 700,000 healthcare professionals nationwide, whether they’re seeking care in their hometown or across the country.

With discounts averaging 42 percent for Doctors and Specialists – the types of services most used on these plans – your members get more value for their performance dollars.

No matter where the members are, they offer various coast-to-coast services. You can contact them at (866) 750-7427 to see how much they can save you on healthcare costs.

3. Minimum plan requirements

The PHCS network is designed to be used with limited benefit plans that provide greater coverage. If your plan does not meet the requirements listed below, your plan may be able to access the MultiPlan network.

4. Quality

In addition to connecting and pulling together many small networks, PHCS has created a national network that enables them to authenticate and re-authenticate their care providers to maintain high-quality health care.

READ ALSO: 13 Best Cheap Health Insurance In Washington (WA)

Compare PHCS health insurance offers

While it is not possible to receive PHCS health insurance quotes from PHCS or MultiPlan, it is certainly possible to receive quotes from insurance companies that use their networks.

Make sure you get multiple quotes from these providers and many others who service your area before making a final decision about your health insurance provider, plan, or policy.

To start shopping for your health insurance, enter your zip code in the field on the right side of the page. Compare the best health insurance now!

PHCS Plans and Coverage 

PHCS offers a variety of plans and coverage options. These include:

  • PPO plans: This plan will allow you to see any doctor or specialist in their network without a referral. You’ll pay less if you use doctors and hospitals within the PHCS network.               
  • HMO plans: With an HMO plan, you’ll need to choose a primary care doctor from the PHCS network. You’ll need a referral from your primary care doctor to see specialists.               
  • Point-of-Service (POS) plans: POS plans combine PPO and HMO plans. With a POS plan, you can see any doctor or specialist in or out of the PHCS network. However, you’ll pay less if you use doctors within the PHCS network.   


The PHCS network allows you to give them access to thousands of hospitals, doctors, and ancillary facilities that have agreed to significant discounts on their medical services.


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