Benefit to Payors

Payors can help lower the cost to their Plan by encouraging patients
to use PCA providers. Members of your Plan should be encouraged
to use PCA providers for the optimal health care savings. Not only
does the Plan benefit from reduced payments, but the patient shares
in the savings through a proportionately reduced co-payment
or balance.

Role of the Payor

Payors are ultimately responsible for adjudicating claims and making
payments to the provider. In an effort to help control health care costs,
payors should encourage Plan members to seek out PCA providers
when they need health care services. Payors can inform members
about this Web site and their ability to identify providers in their
area who are members of the PlanCare America network.

Payors can also examine their historical experience with providers
and encourage the high-volume or high-dollar providers to join the
PCA network and begin to reduce the cost to their Plan.

How Can Payors Steer Members to PlanCare America?

Payors should direct members to this Web site where they can
use the Search for a Provider feature at the top of our home page.
They can print off their own personalized directory of providers
near where they live or work.