What is the Oldest and Largest PPO in America?

Preferred provider organizations (PPOs) have become a popular type of health insurance plan in the United States. PPOs give members flexibility in choosing healthcare providers while still receiving coverage from their insurance. But not all PPOs are created equal. If you’re looking for a large, established PPO network, then MultiPlan is the one you need to know about.

What is MultiPlan?

MultiPlan is the oldest and largest independent PPO network in America. The company contracts with over 1 million healthcare providers across the country, including 98% of America’s hospitals. This gives MultiPlan members access to a vast range of in-network doctors, specialists, hospitals, and other facilities.

So what makes MultiPlan stand out compared to other PPO networks? Here are some key facts about this PPO giant:

• Founded in 1980 – MultiPlan is over 40 years old, making it the oldest major PPO network. Their longevity and experience give them unparalleled reach across providers nationwide.

• Largest network – With over 1.2 million healthcare providers, MultiPlan has the biggest PPO network by far. The next largest PPO has less than half as many providers in their network.

• Wide geographical coverage – MultiPlan has contracted providers in all 50 states and even US territories like Puerto Rico. This extensive coverage ensures members can find in-network care conveniently.

• Broad range of providers – In addition to having the most providers numerically, MultiPlan also has great diversity of provider types. Their network includes major hospital systems, private practices, clinics, ancillary facilities, and more.

• High provider satisfaction – Over 95% of providers within MultiPlan’s network report being satisfied with the PPO. This helps ensure stable partnerships with quality providers over time.

How Does MultiPlan Work?

MultiPlan functions like any other PPO in that they contract with a large network of healthcare providers. They negotiate discounted rates with these providers to offer savings to members.

As an insurance member, you would get care from “in-network” MultiPlan providers to receive the best coverage and pricing. But you still have the flexibility to go “out-of-network” if needed, albeit with potentially higher costs.

Here is a quick rundown of how MultiPlan facilitates coverage:

• Insurance partners – Major insurance companies like UnitedHealthcare, Aetna, and Cigna partner with MultiPlan to access their provider network.

• Member ID access – As a member of an insurance plan partnered with MultiPlan, your member ID card will display the MultiPlan logo and network information. This allows providers to verify your PPO membership.

• Discounted rates – MultiPlan has pre-negotiated discounted treatment rates with in-network providers. As a member, you pay lower pre-agreed rates for services instead of full price.

• Claims handling – In-network providers will submit claims directly to your insurance after treatment. This saves you paperwork and hassle.

• Out-of-network flexibility – You can still visit out-of-network providers, although you may have higher out-of-pocket costs. You may have to file claims yourself after paying the provider.

So in essence, MultiPlan secures you discounted treatment rates within a massive nationwide network. This gives you flexibility and affordability for your healthcare needs.

Benefits of Using MultiPlan

There are many advantages to having access to the MultiPlan PPO network, including:

1. More Provider Choice

With over 1.2 million providers spanning every state and medical specialty, MultiPlan offers unmatched choice. You can easily find an in-network option whether you need primary care, a specialist, hospital, lab work, or other services. No matter where you live or travel, you can conveniently access discounted care.

2. Lower Costs

By using in-network MultiPlan providers, you can save money on your medical bills thanks to pre-negotiated rates. Your insurance premiums may also be lower if your insurer can leverage the MultiPlan network’s discounted pricing.

3. Quality Providers

MultiPlan uses rigorous criteria to screen providers before allowing them to join the network. This ensures you get quality care from reputable providers. Over 95% of current MultiPlan providers report being satisfied with the PPO network.

4. Smooth Claims Processing

When you stay in-network, claims paperwork is handled directly between the provider and insurance company. You avoid the hassle of paying upfront then filing claims yourself for reimbursement.

5. Nationwide Coverage

With providers across all 50 states and Puerto Rico, you have coast-to-coast access to discounted medical care. Wherever life takes you within the US, you can find a nearby in-network provider.

6. Large Hospital Network

In addition to private practices and clinics, MultiPlan has contracted with the majority of hospitals across the nation. When hospital care is needed, you get peace of mind knowing you have in-network options.

7. Freedom of Choice

While financial incentives promote staying in-network, you still have the freedom to visit out-of-network providers if needed. PPOs offer more flexibility compared to restrictive HMO plans.

Types of Plans Offered

You can access the MultiPlan PPO network through various types of insurance plans. Some common plan types linked to MultiPlan include:

• Employer group health plans – Many employers offer healthcare coverage to employees utilizing the MultiPlan network to deliver savings and provider access.

• Individual/family plans – People buying their own private health insurance can often gain access to the MultiPlan network by shopping through participating insurers.

• Medicare Advantage – Medicare Advantage plans that cover senior citizens and the disabled frequently partner with MultiPlan to extend provider choice.

• Medicaid – Government Medicaid programs can enroll members into managed care plans leveraging MultiPlan’s network in many states.

• Workers’ compensation – Employers providing workers’ comp insurance commonly use MultiPlan to deliver savings through negotiated provider rates.

• Auto insurance – Auto policies covering medical expenses related to accidents may also tap into the MultiPlan network.

Across all these insurance options, partnering with MultiPlan gives members access to more providers at lower prices.

How Do I Know If I’m Covered by MultiPlan?

If you’re already enrolled in a health insurance plan, here are some easy ways to check if you have access to MultiPlan’s network:

• Insurance card – Check if your insurance membership card displays the MultiPlan logo. This is the clearest indicator your plan is linked to MultiPlan.

• Insurer website – Visit your insurance company’s website. Search for provider network information to see if MultiPlan or one of their networks like PHCS is mentioned.

• Provider listings – Search for providers on your insurer’s website. MultiPlan providers will be designated differently compared to out-of-network providers.

• Call insurer – Contact your insurance company’s customer service department. Ask the representative to confirm whether your plan grants you access to the MultiPlan network.

Knowing your PPO network access is important to maximize savings and convenience when seeking medical care.

Finding a MultiPlan Provider

Once enrolled in a partner plan, you can easily locate in-network MultiPlan providers near you. Here are some options for finding participating providers:

• Multiplan website – Use the provider search tool on Multiplan.com by entering your location and desired specialty.

• Insurer website – Your insurance company’s website may have a customized “Find a Provider” search for locating in-network MultiPlan providers.

• Provider directories – Printed provider directories from your insurer will highlight MultiPlan providers. These are commonly mailed upon enrollment.

• Call MultiPlan – Speak to a MultiPlan representative by calling 800-950-7040 to get help finding a provider that fits your needs.

• Ask your doctor – Your current doctor may already participate in MultiPlan or can recommend specialists who do.

Always double check that a provider officially participates in MultiPlan’s network before your visit to ensure you receive discounted rates.

MultiPlan PPO vs. HMO and Other Networks

It’s helpful to understand how MultiPlan’s PPO network compares to other common insurance network models:

MultiPlan PPO

• Large nationwide network
• Flexibility to see out-of-network doctors
• No need for referrals to specialists
• Discounted rates for in-network providers

HMO

• Smaller local provider network
• Out-of-network care not covered except emergencies
• Primary doctor referrals required for specialists
• Copays for network providers

Other PPOs

• Varying network size by region
• Flexibility for out