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About Us
The SuperMed PPO network is a Preferred Provider Organization network and consists of provider contracts in Ohio and several counties in Kentucky (Boone, Kenton and Campbell). We work directly with doctors and hospitals to negotiate provider discounts and reimbursement.
Our Relationships with Providers
Network Access Services uses the following tools to determine competitive reimbursement levels for providers and other healthcare professionals:
- Claims history and current payment levels
- Medicare fee schedules
- Health Care Financing Administration (HCFA) resource-based relative value scale
- Wholesale prices (where applicable)
- Financial and statistical indicators
- Geographic physician billing practices
- Site of service (facility vs. non-facility)
Providers who participate in the SuperMed PPO Network agree to accept our negotiated rates as payment in full for covered services. They are also required to take part in managed care initiatives aimed at reducing costs and verifying the medical appropriateness of all procedures.
Our Relationships with Hospitals and Healthcare Facilities
We contract with hospitals using varying methods of reimbursement, depending on the facility's volume of claims and utilization patterns. These payment methods are flexible to accommodate the facility’s specific needs and other incentives to help control costs and utilization by:
- In patient diagnosis-related grouping
- Per diem rates
- Percent-off charges
- Outpatient ambulatory patient grouping
- Charge increase limitations
- Inlier and outlier minimums and maximums
- Fixed outpatient pricing
Our Relationship with our Customers and Members
Network Access Services is proud to offer our customers and members with the highest quality of service and standards.
- Claims are submitted directly to Medical Mutual to eliminate unnecessary paperwork for members.
- Customers and members can contact Network Access Services to request a provider or facility be added to the SuperMed PPO network; we’ll reach out to initiate discussions