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Identifying Participants

Currently, an estimated 40 million health plan participants have access to the MultiPlan and PHCS networks. Health plans that use the networks are responsible for providing their participants with evidence that they are eligible to access the networks. Most health plans meet this requirement by providing their participants with identification cards that indicate an affiliation with PHCS and/or MultiPlan.

The sample ID card front and back shown below illustrates access to the PHCS Network for primary PPO access, and The MultiPlan Network for complementary access. If you have questions about how to identify participants eligible to access the MultiPlan and PHCS networks, visit our FAQ section or call our Service Operations department at (800) 950-7040.

We also recommend that you contact the patient's health plan to obtain eligibility information before rendering any services. You can do this by calling the number on your patient's identification card.

Sample ID Card Front Sample ID Card Back

The card will typically also list, on the card front and/or back:

  • Plan participant information;
  • Co-payment or encounter fee amount;
  • Claims address; and
  • Separate telephone numbers for obtaining eligibility and benefit information, for Network referrals, if applicable, and for pre-certifying treatment.

Other Ways to Identify Plan participant
Please note that some participants may continue to carry an ID card featuring older PHCS and/or MultiPlan logos. The logos representing primary PPO access are shown below. Participants carrying older ID cards with these logos have the right to access the PHCS Network on the same basis as those carrying an ID card featuring the new PHCS Network logo.

The older logos representing national complementary network access are shown below:

In rare circumstances you will receive direct notification from the participant's health plan (via phone or fax) identifying the PHCS Network or The MultiPlan Network as the participant's network. Also in limited circumstances and with prior notification to impacted providers, the client's logo, and not MultiPlan's will indicate access to The MultiPlan Network.