Payer Contracting

As a messenger model, Paramount Health Options (PHO) gathers requests from members and shares those requests with payers. A unified voice to the payer community creates consistent contracts and revenue predictability, which reduces administrative burden for medical practices. Payer contracts are evaluated using committees consisting of clinic and hospital executives, billing staff and physicians. Currently, PHO holds contracts with 17 payers, representing 31 products.

PHO's current Payer Listing:

• Aetna HMO and PPO
• Aetna Medicare Advantage HMO and PPO
• Aetna First Health PPO
• Corvel Corporation - credentialing only
• Especially for You - by invitation only
• Health Alliance Commercial
• Health Alliance Medicare
  
• HealthPartners, Inc. PPO
• HealthPartners, Inc. Medicare Advantage
• HealthSmart PPO
• Humana Choice Care Medicare Advantage HMO and PPO
• Humana Commercial
• Iowa Total Care AmBetter - effective 1/1/2025
• Iowa Total Care Medicaid
• Iowa Total Care Wellcare - effective 1/1/2025
• Medical Associates Medicare - by invitation only
• Medical Associates-Health Choices - by invitation only
• MedRisk - available to MTN only
• Midlands Choice PPO
• Midlands Medica Cost Plan - by invitation only
• Molina Medicare Advantage/DSNP - effective 1/1/2025
• Molina Medicaid
• O'Hara Workers Compensation Network PPO
• Tricare West
• UHC HMO, PPO, Medicare Advantage, VACCN - credentialing only
• Wellmark PPO
• Wellmark HMO
• Wellmark Medicare Advantage     
• Wellmark Value - by invitation only
• Wellpoint Medicare DSNP (Formerly Amerigroup Iowa, Inc.)
• Wellpoint Medicaid