Let’s tell it like it is

Encore Health Network is…

  • Transforming the traditional PPO Model into one that allows its Members, Employers, Payor and Brokers to offer an alternative product to the market that has best commercial pricing within the Indiana market to control healthcare costs.
    • A rental PPO network that provides three network products

    • Encore Network provides are payors and members with expansive network access and competitive pricing.
    • Encircle Network is our EPO network that provides best commercial pricing in selected markets within a narrower provider network.
    • Encircle/Encore Combined provides our clients with the deepest and best commercial pricing within a three tiered benefit plan and complete network access. It is the best of both worlds.
  • The largest independent provider-owned PPO network in Indiana not owned by a carrier.
  • The only local network with a key relationship with The Clarian Transplant Network that provides Encore members with access to a National Center of Excellence in transplant services, as well as cost savings benefits uncommon in this area of healthcare service.
  • known in the Indiana health network marketplace for its growing access to top clinicians, ancillary providers, and hospitals; its flexibility and competitive pricing; and its relationship building with and service to employer groups, brokers, payors, and TPAs.
  • Provides access to 171 hospitals and more than 31,000 physicians in Indiana and some counties of operation in contiguous states (Ohio, Michigan, Kentucky, and Indiana)
  • Offers access to 1835 ancillary providers (e.g., medical imaging centers, physical therapists, home healthcare services, and hospice)
  • Offers unique discount programs at no additional cost to all Encore members such as ChooseHealthyTM, an alternative healthcare program, QualSight Lasik Surgery Discount Plan, VSP Vision Discount Plan, and EPIC Hearing benefits.
  • Has a national affiliation relationship with USA MCO and Superien Health Network that benefits Encore members whenever traveling outside of Encore’s coverage area anywhere in the United States

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My Payor Download



If you have any questions, please contact webmaster@encoreconnect.com
Special Authorization is required to access the Payor Updates.
Please contact one of the following Account Executives for access:
· Holly Joyce at (317) 621-4263 or hjoyce@encoreppo.com, or
· Kevin McShay at (317) 621-4264 or kmcshay@encoreppo.com

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Notice

Encore has entered into a new arrangement for chiropractic services with HSM, Inc. HSM, Inc., a Minnesota-based specialty network services organization, will administer the chiropractic network for our Encore and Encircle service areas.

HSM will directly hold contracts with all participating chiropractors; therefore, there are some changes of which you should be aware. Regarding billing, chiropractors will now send their claims directly to HSM. HSM will collect the data in their system, including treatment plans for case management, and forward claims to the appropriate Encore payor. The payor will send all payment directly to HSM, who will in turn reimburse the chiropractor according to the negotiated rates.

If you are interested in becoming a participating chiropractor in the Encore Health Network, please contact HSM at 800-432-3640 or visit their web-site at www.hsminc.com.

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Current Worker's Comp Payors

Arete USA D/B/A The Covenant Companies
HealthSmart
HFN, Inc
Indiana University
InterPlan Health Group
IU Health Plan
MCMC LLC
ASU Group
Major Hospital
ACS CompIQ Corporation, A Xerox Company

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Payor and Provider Resources

Payors please contact Account Executive Kevin McShay at (317)621-4264 or kmcshay@encoreppo.com for access.

For any provider issue, please contact Provider Contracting Coordinator, Tina Bilodeau at (317)621-4269 or tbilodeau@encoreppo.com.