RESOURCE PARTNERS

Helping Us Serve You Better!

PPO NETWORKS

Santa Fe Preferred Healthcare has partnered with the best PPO networks in the industry which include some of the nation's finest hospitals, physicians, and health care professionals.  Santa Fe Preferred Healthcare maintains many other PPO relationships based on client needs.  The most popular local and national networks are listed below. 

                                                                                

 

 

 

 

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EMPLOYER HEALTH OPTIONS, INC. (EHO)

EHO has been processing prescription claims for hospices, self-insured companies and municipalities, worker’s compensation, and insurance groups since 1994. EHO provides advisory, administrative, and technological services to multiple national and regional managed prescription benefit programs. By utilizing technological, administrative expertise, and cooperative agreements with pharmacy networks, EHO has been able to bring about significant reductions in overall medication costs.

EHO specializes in managing the prescription benefit plans with a need to both control prescription plan costs and provide participants with a valued benefit. The client will realize cost reductions while satisfying the healthcare needs of their employees by working with EHO to develop a unique benefit structure and plan design. EHO is known as an industry leader in providing the lowest prescription cost to its clients.

800-650-1817 or 254-771-6000

 

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Spectrum Review Services (SRS) offers a broad variety of medical review services for insurers and claim management entities. Unlike other review businesses, Spectrum distinguishes itself through highly personalized service. When you call Spectrum, your first response will never be a machine. Instead, your interactions will be highly personal and tailored to suit your particular medical management needs.

 

Members of the Spectrum Review team include specially trained nurses and physicians. Peer review physicians have been recruited nationally from private practices as independent contractors so that they may offer specialized, physician-to-physician case review for cases not meeting widely accepted national ISSI type criteria.

• Precertification  / Utilization

• Case Management

800-258-5055  or 281-444-2194

　

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In order to support the recommendations provided through the analysis process, Ecom has developed an integrated suite of claims management services that provide compelling administrative efficiency and operational cost savings. These services utilized by Santa Fe Preferred Healthcare include:

 

• EDI Intake - Ecom manages the connectivity to clearinghouses and other trading partners handling electronic claims.

 

• Claim Translation & HIPAA Compliance - Ecom translates claim files to the required formats required by PPO networks and clearinghouses in HIPAA compliant EDI standards. 

 

• Decision Support - Ecom offers standard and ad-hoc reporting via Client Web Tools.

 

Ecom streamlines the administrative processes for the client, therefore improving administrative costs and improving operational efficiency for each customer. Further, Ecom has allowed the client to focus on their core business of delivering and managing healthcare to its members.

1-866-326-6776 (toll free) ~ 214-561-6301 fax

 

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Disclaimer
Santa Fe Preferred Healthcare attempts to maintain the highest accuracy of content. Information may be changed or updated without notice. Santa Fe Preferred Healthcare may make improvements and/or changes in the materials contained in or described on this web site at any time without notice. Santa Fe Preferred Healthcare may also make changes in this disclaimer without notice. It is recommended that the user periodically visit this page to review the current disclaimer.

The information provided on this site is designed to support, not replace, the relationship that exists between a site visitor and his/her existing health care provider. Always seek the advice of your doctor or other qualified health provider before starting any type of new health related program. Talk with your health care provider about any questions you may have regarding a medical condition. Nothing contained in the service is intended to be for medical diagnosis or treatment.

 

 

Santa Fe Preferred Healthcare will be happy to answer your questions.

Please contact us at 1-800-334-1330 ext 306 or click to email