Managed Care that Works for Everyone
Prime Network Provider Spotlight
HOMESTEAD HOSPITAL

HOMESTEAD, FL
   Request a Quote
PPO Network Quote Thank you for considering Evolutions Healthcare Systems for your PPO needs. For your convenience the list of questions below details the information needed to provide a network quote, GEO Report, CPT Analysis, or Disruption Report. We have a full-time staff of Inside Account Managers to assist you with your questions and requests.

Standard Information

· Requestor’s name, phone, and email address

· The TPA Account Manager, phone and email address (if different)

· Plan Sponsor Name and Address

· Current plan effective date and proposed plan effective date

· Current Administrator if this is a new business opportunity

· Broker’s Name and Contact Information

· Current health care network affiliations

· Product Requested:

   Prime Network - Our Carrier-level Provider Network
      offered throughout Florida
   Prime Plus Network – A complementary Provider Network
      that expands the Prime Network for National Coverage
   Select Network - Our highly-rated National Preferred
      Provider Network
   Select Plus - (a.k.a., Advantage or Preferred Network) -       A complementary multi-network solution offering       extended national provider coverage


Additional Information Required for:

GEO Report

· Employee census information including sex, birth date, and employee zip codes (Please submit in Microsoft Excel)

· Access Standards (i.e. 1 Hospital within 25 miles, 1 PCP within 15 miles)

· Average number of employees on payroll each month for the past three years

CPT Analysis

· List of CPT codes to be referenced

· List of Facilities or Zip codes for analysis

· Most recent twelve months claims experience

Disruption Report

· List of 7 digit provider tax identification numbers

· List of Provider Names

· List of Provider Addresses


Submit Request for Proposal

Please submit your RFP and census information electronically (Word or Excel) to sales@ehsppo.com. Or you can mail hard copies and diskettes to:

Evolutions Healthcare Systems, Inc.
PO Box 5001
New Port Richey, FL 34656
Attn: Sales Department

For additional Information please contact the Sales Department.