Notices and Updates
Notices and Updates
Prime Health Services IGS Provider Announcement 12/7/2022
With the recent announcement of our acquisition of the InterGroup provider network, we are pleased to welcome you to Prime Health Services, Inc., a national cost management solutions company.
Per the Assignment section of your existing contract, Intergroup has assigned your provider agreement to Prime Health Services, Inc.
With this transaction set to close on 12/31/22, clients will continue to access you for needed services, and payments to providers will continue as they do today. Any updates to your data can be submitted to updates@primehealthservices.com, and for DOS 1/1/2023 and after, any disputes related to pricing or application of the contractual rates can be submitted to disputes@primehealthservices.com.
As Prime Health merges the provider demographics and rate information into our system, we will also bring over any existing credentialing details and your current credentialing review cycle will remain active. Any inquiries specific to credentialing can be submitted to credentialing@primehealthservices.com.
For DOS after 1/1/2023, you will no longer see any indication of the Intergroup (IGS) network name on EORs. All bills processed will display PHS or Prime Health Services and any of our affiliates.
General questions not related to the topics mentioned above can be submitted to Provider Relations providerrelations@primehealthservices.com.
Again, welcome to the Prime Health Services network and we look forward to a successful relationship.
No Suprises Act
Beginning July 1, 2022, health care providers will need to:
• Submit the CMS-1500 form. Electronic submission through an XML submission partner is strongly encouraged, though not required. When mandatory submission of the CMS-1500 form begins, use of current medical billing/reports including Doctor’s Initial Report (Form C-4) and Doctor’s Progress Report (Form C-4.2) will be discontinued.
• Prominently report the injured worker’s temporary impairment percentage, work status and the causal relationship of the injury at the top of the CMS-1500 form medical narrative.
Between now and July 1, 2022 health care providers are urged to review their processes to understand how these changes will affect them. The Board will continue to post periodic updates to the website based on feedback and questions received from stakeholders.
Attention New York Health Care Providers: CMS-1500 Updates
Beginning July 1, 2022, health care providers will need to:
• Submit the CMS-1500 form. Electronic submission through an XML submission partner is strongly encouraged, though not required. When mandatory submission of the CMS-1500 form begins, use of current medical billing/reports including Doctor’s Initial Report (Form C-4) and Doctor’s Progress Report (Form C-4.2) will be discontinued.
• Prominently report the injured worker’s temporary impairment percentage, work status and the causal relationship of the injury at the top of the CMS-1500 form medical narrative.
Between now and July 1, 2022 health care providers are urged to review their processes to understand how these changes will affect them. The Board will continue to post periodic updates to the website based on feedback and questions received from stakeholders.
