When and why was the company founded?
ppoNEXT was founded in1999 by health industry leaders who recognized a tremendous market need for a health service provider who could offer innovative provider network products, administrative and cost solutions for employers being squeezed by rising insurance costs and employees demanding greater choice and flexibility in health coverage.

What distinguishes the ppoNEXT health plan from others?
ppoNEXT is characterized by nine points of distinction:

1. ppoNEXT is the nation's fastest growing, independent healthcare services network.
2. ppoNEXT was built through a national acquisition strategy. By acquiring and consolidating three regional and two national PPO networks, ppoNEXT has developed a network of participating providers that is among the top three in the nation in size (450,000 physicians and 3,700 hospitals in 50 states).
3. ppoNEXT has consolidated all of its businesses onto one Web-enabled processing platform.
4. ppoNEXT's provider network has the geographic expanse of a national network with the market depth and discount levels of a regional player. It is a "national network with a regional flair."
5. ppoNEXT's customers include more than 800 payor/administrator and 8,000 self-funded employer customers who collectively finance healthcare benefits for more than 3 million people.
6. ppoNEXT owns 90% of their provider contracts and thus controls its product. This enables the company to customize products and services that best meet its payor-clients' unique needs.
7. ppoNEXT is one of the few health networks using state-of-the-art, Web-based technology to provide online administrative services. With ppoNEXT's claims-processing technology, customers can reprice claims electronically reducing the administrative burden experienced with most PPOs.
8. ppoNEXT offers geographic access to a national network of healthcare providers, competitive discounts from retail medical charges and an easy and flexible administrative interface that comprise a "one-stop" shopping opportunity for customers who wish to consolidate their managed care purchasing.

What advantages does ppoNEXT offer?
ppoNEXT brings value and distinct benefits to customers and members, including:

• One-stop shopping for customers seeking a national network of healthcare providers with a flexible, timely and cost-effective administrative interface.
• Broad access to a national PPO with the deep provider discounts of regional players. Overall savings average 33 percent on inpatient charges, 21 percent on outpatient hospital services and 29 percent on physician services.
• Flexible claims processing. Clients may electronically submit or receive claims via the Internet, electronic data interchange (EDI) connections, scanned images or paper to be processed in-house.
• State-of-the-art, Web-based claims-processing technology that allows customers to reprice claims online and allows members to view their company-specific provider listings.
• Greater flexibility to meet client needs due to product control that comes from owning its contracts with healthcare providers. Services are made possible through cooperative arrangements with respected partners in the medical community.
• A one-of a kind stop-loss product for self-insured employers brought to them in conjunction with ten of the top reinsurers in the country.
• A customizable provider network that continues to grow geographically through an aggressive expansion strategy allowing clients to meet their own strategic expansion needs throughout the country.
• A commitment to customer excellence and successful "business partnerships," which includes a nationwide customer service center and dedicated account management, provider relations and marketing teams.
• An online provider directory that allows members to search for network providers 24 hours a day, 7 days a week.
• Online inquiry regarding claims status that allows members and participating providers to know when their particular claims have been processed.

Where is ppoNEXT available?
The program is available nationally.

How does one obtain the ppoNEXT provider network or other products?
You may call the ppoNEXT Sales and Marketing Department at 1-888-446-6098, ext. 5613.

What type of customer service do you offer?
Our Customer Care Representatives can help you with provider referrals and claims status, resolve issues and answer questions. You can reach our Customer Care Center at 800.860.6381 between 8 a.m. and 5 p.m. Central Time, Monday through Friday.

How do I find a network provider?
The Find a Doctor section of this web site allows you to search for a provider by name, specialty, city, or zip code, and for a facility using city and name. Maps to provider locations also are available. Or you can call ppoNEXT Customer Care at 800.860.6381 between 8 a.m. and 5 p.m. Central Time, Monday through Friday, and a representative will assist you.

How can I find out if my doctor is in the ppoNEXT network?
Click here on Find a Doctor to search for a provider by name, specialty, city, or zip code, and for a facility using city and name. Or call ppoNEXT Customer Care at 800.860.6381 between 8 a.m. and 5 p.m. Central Time, Monday through Friday, and a representative will assist you.

What is a "preferred provider"?
A Preferred Provider is a prescreened doctor, hospital or other health care provider that has agreed to provide services at predetermined rates. The providers in ppoNEXT's PPO (Preferred Provider Organization) Network are your "preferred providers" of medical care.

What is a "primary care physician"?
Generally, a primary care physician is one who specializes in Family Practice, General Practice, Internal Medicine or Pediatrics. A primary care physician is the doctor you see first for any medical condition you might have. We recommend you contact your insurance company or claims payor directly at the phone number on your ID card to clarify the specifics of your benefits and coverage. Or you may contact your employer's Human Resources or Benefits office for assistance.

What is a payor?
A payor is someone who funds and pays the medical costs. Payors can be entities such as Third Party Administrators (TPAs), Self-Funded/Self-Administered Employer Groups, Taft-Hartley Trust Funds and Insurance carriers.

How does one obtain the ppoNEXT provider network or other products?
You may call the ppoNEXT Sales and Marketing Department at 1-800-860-6381.

Where can I get more information?
You can get more information by calling 1-800-860-6381.