Procura Management

Hospital and Physician PPO Network

National Networks. Regional Expertise.

Hospital and physician expenses present the greatest opportunity to achieve savings and combat rising medical costs. Through a combination of national affiliations, as well as regional and proprietary networks, Procura provides seamless access to the country’s strongest providers. This results in greater network penetration at preferred rates, improved outcomes for our customers, as well as simplified administration for adjusters and payers.

Procura’s prospective networks allow treatment protocols to be applied from inception of medical treatment. The success of the network is based on savings, quality and accessibility:

  • Savings are achieved through assertive contract negotiations and optimal penetration rates
  • Quality is achieved through rigorous credentialing of network providers
  • Accessibility is achieved through persistent monitoring of qualified providers by location to ensure convenient access by claimants

The Procura network is comprised of participating providers who are available to claimants, ensuring immediate access to qualified providers and maximum penetration rates. Network utilization is maximized by having network directories available through a secure Internet-based tool with customer-specific online search features and electronic directories.

Procura prides itself on attention to detail throughout the process of credentialing and re-credentialing of network providers. Profiling is accomplished through documenting and measuring provider performance to quality standards in such areas as cost by ICD 9 or duration of disability by ICD 9. Provider performance is consistently documented and measured.

Out of Network Negotiations

In order to realize global savings across all bills, Procura has developed a non-network negotiation program to work in conjunction with our Network savings. Non-network bills are channeled to the negotiation team for efficient and effective processing, providing a total management solution.

Bundled or Unbundled Services

Procura’s PPO network can be an embedded feature of our bill review program, or available as an unbundled service, fully automated through pend and transmit capabilities.

Contact a Procura representative to learn more about our hospital and physician PPO network services.