We’re glad you participate in the network

Encore is the health network that cares. We provide access to doctors your patients know, and hospitals they trust


Our Claim Appeals process!!!! Encore Health Network has been busy streamlining our claim appeals process by developing an on-line claim submission platform for our payors. To access the new Claims Appeals application, payors should click on the green button labeled Claims Appeals. Payors need to login to website. If payors do not have a login, please register for the website. Permission to the site is approved within 24 hours. Once approved, then click on the green Claim Appeals button and fill out the form field as appropriate.

Please note that this application is not a vehicle for claim status (which Encore currently does not have an on-line option) or new claim submission. New claims need to be submitted to Encore via EDI connection OR mailed.

If you have any questions or need assistance, please contact your Payor Account Manager.

Join the evolution of healthcare …Encore

As the largest provider owned PPO network in Indiana, with tens of thousands of physician locations and hundreds of hospitals, Encore provides brokers and payors with a diverse suite of network products for your employer groups that offers exceptional savings and service. Encore is not a publicly traded company beholden to shareholders. Encore’s main focus is Indiana employers and their employees. Our networks are:

    • EncoreCombined Network gives our employees the best of both worlds – expansive network access and top tier pricing.
    • EncorePrime Network provides members with the deepest savings in selected markets
    • Encore Health Network PPO provides the most extensive network access.
    • Encore Workers Compensation PPO Network – Back to work and life with our workers’ compensation PPO network.

In addition, Encore also offers national network coverage through its various partnerships; your clients are covered wherever they are. We also have developed relationships and maintain consistent competitive rating with various reinsurance carriers to ensure your employer groups get the best stop-loss quote. Encore continues to enhance our repricing systems, maintain a high repricing accuracy with fast claims turnaround time, and live customer service representatives to serve your needs.

In addition to our savings, you simply won’t find a network with a better lineup of complimentary programs anywhere in the state. Encore members receive discounts on vision and hearing service plans through the largest providers in the nation-VSP and EPIC. 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.

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

Sales Team

Rochelle Hankins 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




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


    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.

    Current Worker's Comp Payors

    Arete USA D/B/A The Covenant Companies
    HFN, Inc
    Indiana University
    InterPlan Health Group
    IU Health Plan
    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, Logan Joyce at (317) 621-4262 or ljoyce@encoreppo.com.