Doctors: Private Health Care Systems (PHCS)

Provider Network: Over 525,000 healthcare professionals, and over 66,000 ancillaries
Discount Range: 20% to 45% savings

Example of Average Savings
Based on monthly snapshot - 2008

Provider Specialty Discount
Allergy 57%
Cardiovascular 35%
Clinical Psychology 19%
Dermatology 44%
Diagnostic Radiology 31%
Emergency Medicine 41%
Endocrinology 48%
Family Practice 32%
Gastroenterology 38%
General Practice 37%
Gynecology 35%
Internal Medicine 55%
Laboratories 74%
Neurology 49%
Orthopedic Surgery 35%
Pain Management 45%
Pediatrics 37%
Physical Therapy 44%
Plastic Surgery 61%
Podiatric Surgery 36%
Formulated Health Plan brings a significant competitive advantage to clients through the personalized, concierge service with which they administer their physician discount program.

Members of Formulated Health Plan's nationwide discount program receive an identification card and "Dear Doctor" letter in their fulfillment kit with instructions to call the Physician Relations Department where a live operator will provide them with a list of providers, and verify participation of those providers. The members will then call and schedule an appointment with the participating provider.

The Physician's Relations Department will also instruct the provider to contact them at the time of checkout and give the CPT codes for the services rendered. We will then communicate to the provider the PHCS allowable amount and instruct the provider to collect this entire amount. This may be done via phone, fax, email, or regular mail.

The live operator feature with the PHCS option ensures that the member's experience is a positive one with very little room for error or confusion on either the member's or the doctor's part at the time of service.

Key Features of PHCS:

  • PHCS is the largest proprietary PPO in the country with nationwide access
  • The live-operator feature ensures a positive member/provider experience
  • Providers must pass strict credentialing criteria
  • PHCS has relationships with providers associated with the majority of specialties

How to Access Your Discounts

  1. Locate a participating provider by calling your toll free number (see membership card) for the name, address and phone number of a provider in your area. The Physician Relations department will verify participating provider(s) in your area. Members may then call to set up the appointment.
  2. Present your membership card when you arrive at the provider. Your membership card instructs the provider to call or fax Physician Relations for the negotiated rate agreed upon in their contract with PHCS.
  3. Remember, you are responsible for paying the hospital the entire discounted fee at the time service is provided.