It’s all about the location with Encore Prime

Launched in 2019, the EncorePrime® Network is our hybrid network developed to contain rising healthcare costs while providing an exclusive network of physicians and hospital committed to delivering the highest quality healthcare serves available. Employers recognize that affordable healthcare benefits are important to their employees, without compromising quality. The EncorePrime® Network is cost effective for both employers and employees, with claims savings, deeper discounts, and reinsurance discounts – better pricing and lower premiums. What’s more, it satisfies your local healthcare needs.

The EncorePrime® Network provides employers and payors with the following:

  • Geographically specific network with no gatekeeper*
  • The best commercial pricing
  • An exclusive network with all specialties represented
  • Can be offered as an EPO or a Tiered Product with Encore Health Network PPO
  • Can also be offered as a dual choice with Encore Health Network PPO
  • Can be wrapped by a National Network
  • Affordable network access rates (pepm) that helps maintain low administrative costs
  • Access to Encore’s Value-added products

*EncorePrime is currently marketed only in Evansville at this time.

Value-Added Products
In addition to savings, you simply won’t find a network with a better lineup of complimentary programs anywhere in the state. EncorePrime members can receive:

  • VSP – discounts on vision and hearing service plans through the largest providers in the nation-VSP and
  • EPIC – hearing service plans through the largest providers in the nation
  • Qualsight. Encore is also the only PPO in the state of Indiana that offers savings of 40% to 50% off the overall national average price for LASIK through Qualsight.
  • And should the need arise, members also benefit from Encore’s relationship with IU Health Transplant Center in Indianapolis, both in the renowned quality of service and in cost saving benefits.

Why Encore? Because it means more savings, more coverage, and more of what your employees are looking for in a health network.

For more information, please contact a member of our Sales and Payor Account Management teams:

Shawn Gibbons, VP of Development at (317) 621-4260 or email at sgibbons@encoreppo.com

Sales Team

Rochelle Forrest at (317) 621-4261 or email at rforrest@encoreppo.com

Eric Meadors at (317) 621-4109 or email at emeadors@encoreppo.com

Bert Sorenson at (317) 868-4269 or email at bsorenson@encoreppo.com

Payor Account Team

Fred Douse at (317) 621-4265 or email at fdouse@encoreppo.com

Kevin McShay at (317) 621-4264 or email at kmchsay@encoreppo.com

EMERGE. EVOLVE. EXCEL. ENCORE

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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 your Payor Account Manager, Fred Douse at (317) 621-4265 or fdouse@encoreppo.com or Kevin McShay at (317) 621-4264 or kmcshay@encoreppo.com
PROVIDERS: Please contact Provider Contracting Coordinator, Tina Bilodeau at (317) 621-4269 or tbilodeau@encoreppo.com.