Frequently Asked Questions
How can I find a local provider?
To search for healhcare providers in your area, click on Search and set your location.
You do not need to fill in all of the form fields. Filling in only the zip code will provide a more select number of providers. To broaden your search fill in only the county name.
How do I change my Location?
To change your location, simply click the CHANGE button located on the top right corner of the Search Filters box as seen here:
Then simply follow the same steps for setting your location listed above.
Is my current Doctor in your network?
To locate a specific medical provider, click on Search and fill out the form. Please be aware that you must type in the correct spelling to find a specific provider. You are not required to fill in all the form fields.
Why is my provider not listed in your network?
There could be a number of reasons why your medical provider might not show up in the provider search. Please check the following common reasons and try your search again:
- Spelling mistakes—Please verify the spelling of your provider’ name and double check there are no other spelling errors on the form.
- Incorrect location—On occasion, the provider’s location is entered incorrectly. Please verify.
- Too specific criteria—Please remove some of the criterial (like small radius, specific specializations, etc.) to broaden your search. That may help find the provider you are trying to search. Tip: Try typing a few letters of the provider’s name instead of the entire name (i.e. A Smi instead of Alex Smith). Sometimes that helps.
If there is more than one healthcare provider in the medical office I go to will they all be in the Prime PPO network?
Usually, but not always. Some medical providers contract with Prime Health Services via their practice name or Federal Tax ID Number (TIN); in those cases all of the doctors or other medical providers are covered. However, sometimes medical providers choose to not participate with us even though their associates do.
The only way to know for sure is to check our Provider Search tool or to contact Prime Health Services toll-free at 1-866-348-3887.
Can I enroll my provider in your network?
Absolutely! We are continually building our network of providers so welcome all referrals. Click on Nominate Provider and enter as much information on the form as you can, for the provider you would like to nominate. The Prime Health Services Contracting Department will immediately contact the provider to join our PPO network.
What should I do if my doctor bills me for the balance of a work-related injury claim
Contact your workers’ compensation insurance company if you are billed for a work-related injury claim. Ask them to send the following to firstname.lastname@example.org with “Employee Claim Dispute” in the subject line:
- Brief description of what the provider is disputing (what you are being charged for)
- A copy of the claim
- The EOR (explanation of reimbursement)
Or they can send a fax to 615-329-4411 at the attention of "Employee Claim Dispute."
How accurate is this information?
We make every effort to ensure that the list of providers/practitioners displayed is up to date and accurate. Prime Health has a dedicated Updates Department, Call Center Department, Credentialing Department, and Data Quality Management Department that has ongoing projects to ensure our data has the most up to date information. All changes made by our provider updates staff are made in real time so that our clients realize the changes and additions immediately.
Nashville, TN Area: (615) 329-4098
Prime Health Services, Inc.
331 Mallory Station Rd
Franklin, TN 37067