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- Mission Statement
Nevada Preferred Healthcare Providers (Nevada Preferred), the only Nevada-based, independent statewide PPO network is the result of a partnership between Catholic Healthcare West and Universal Health Services, Inc., who joined their Nevada medical PPO network businesses August 1, 2009. Nevada Preferred now owns and manages the well-known networks of:
Note: Nevada Preferred does not pay claims.
Please refer to your ID card, summary plan document, human resources department or insurance broker for the contact information of the third party administrator (TPA) that pays your claims.
The role of a preferred provider organization (PPO) is to provide a quality medical network including hospitals, physicians and ancillary services for employers, insurance companies and managed care plans. Nevada Preferred provides one of the largest statewide networks available in Nevada and surrounding areas. Our commitment is to offer a CHOICE of providers at competitive market rates that best serve employers and their employees. Our core business is our network products, with complete focus on our services.
Network Access -- Nevada Preferred contracts with medical providers, including but not limited to hospitals, physicians, ambulatory surgery centers, home health agencies, mental health providers and laboratories for discounted rates for medical services. Nevada Preferred's comprehensive Nevada network includes border areas of California such as Truckee, Susanville and South Lake Tahoe and Bullhead City in Arizona.
Claim Repricing -- Clients (employers) who select this service instruct their insurance company or third party administrator (TPA) to print their ID cards with the Nevada Preferred address. This directs provider claims to the Nevada Preferred office where the contractual discount is applied. The claim is promptly forwarded to the payor for adjudication and payment to the provider. Both electronic (EDI) and paper claims are accepted.
Utilization Management (UM) -- UM services include catastrophic case management pre-authorization, concurrent review and discharge planning. UM information is printed on the member's ID card.
Club Health Total Health Management -- This program is offered to target both high-risk and low-risk members, helping them improve their health and slow disease progression, and providing wellness education for healthy members to help them stay healthy.