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CHN PPO
CHN PPO Mitigates Healthcare Costs While Ensuring Affordable, Quality Medical Care
Our fully credentialed network of PPO providers are specialists in Auto/PIP, Workers Compensation, and Group Health
A Division of Medlogix, CHN PPO is a leading preferred provider organization based in northeastern United States with a premier, fully credentialed network of over 228,000 health care providers.
As the cornerstone of our network, our top-quality health care providers are highly skilled in diagnosing and treating automobile and workplace injuries. Our participating provider agreements cover Workers’ Compensation, Group Health and Auto (PIP).
CHN PPO is a better connected, fully integrated custom solution to traditional PPO networks. We bring everything in-house, stay close to our providers, reduce costs, and integrate every part of the claims process. That's the CHN PPO Difference.
National carriers trust CHN PPO for our committed staff, customizable services, and flexible network configurations that provide seamless access nationwide.
- Seamless integration with our MyMedlogix software.
- In-house credentialing process adhering to strict URAC and NCQA standards, including primary source verification of Licensures, Accreditations, Board Certification, Fellowship training, or any additional certifications.
- Ensure patient receives the appropriate treatment in the right setting.
- Seasoned Provider Relations team, with an average tenure of 17 years and leadership boasting 28 years of experience.
- Strong provider network relationships and partnerships.
CHN PPO partners with other regional and national networks to offer our customers a seamless coast to coast PPO network.
Through these direct network contracts and our national network of PPO affiliates, CHN PPO delivers a competitive edge to the clients we serve. CHN and our PPO network partners maintain the appropriate credentials and compliance in all states.
- Less than one percent appeal rate on provider payments as a result of highly accurate bill repricing/contract application.
- 96% of provider bills processed within 24 hours.
- 98% of manual PPO re-pricing processed within 48 hours.
- Detailed reporting to track utilization trends.
- A dedicated Data Integrity Team maintains provider records, including NPI, TIN, and fee scheduled data.
FREQUENTLY ASKED QUESTIONS
Yes, CHN can design client-specific network configurations based on real utilization data, ensuring flexibility and performance across all lines of business.
While headquartered in the Northeast, CHN PPO offers national access through direct contracts and affiliate partnerships, with strong provider concentrations in NJ, NY, PA, CT, MA, NH, VT, and RI.
MyMedlogix is CHN PPO’s web-based platform for real-time claims management, bill review, PPO rate application, and analytics—helping clients identify cost trends and improve outcomes. MyMedlogix integrates directly with your system, eliminating third-party delays and supporting real-time claims, billing, EDI, and analytics.
CHN PPO
CHN PPO Group Health offers employer groups an affordable healthcare solution through a network of over 228,000 providers, featuring real-time claims management. Key features include cost mitigation with fixed-rate contracts, a comprehensive provider network, add-on services like pre-certification and case management, and a customizable platform with integrated MyMedlogix software. The service emphasizes a patient-centered approach with experienced medical staff, ensuring quality care and medical expense control. Group health services encompass pre-certification, utilization management, large case management, medical bill auditing, bill negotiations, and field case management.
More information:
What is PPO Billing?
CHN PPO Group Health offers real-time claims management. Key features include cost mitigation with fixed-rate contracts, a comprehensive provider network, and a customizable platform. The service focuses on medical expense control.
What is PPO?
A Preferred Provider Organization (PPO) is a type of health insurance plan that allows members to seek medical care from doctors, hospitals, and other healthcare providers within a specific network. Unlike Health Maintenance Organizations (HMOs), PPOs typically do not require members to choose a primary care physician (PCP) or obtain referrals to see specialists. This flexibility allows members to access a wider range of healthcare services without the need for prior authorization, although seeing in-network providers usually results in lower out-of-pocket costs.
Is PPO better than HMO?
PPO plans offer more flexibility, allowing you to see specialists without referrals and choose out-of-network providers, though at a higher cost. HMO plans are typically more affordable with lower premiums and out-of-pocket expenses, but they require you to select a primary care physician and obtain referrals for specialists. The "better" choice depends on individual needs and preferences regarding cost, flexibility, and provider selection.
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