Health plan credentialing and contracting are two separate tasks.  While Primoris is primarily a credentialing network, it does have contracts available for most plans.  Through Primoris, an entity will establish whether it wants to use the Primoris contracts or their own.  The Primoris contracts are NON NEGOTIATED rates.  They are what we refer to as “street rates”.  They are the same rates an entity would receive if they had contacted the health plan themselves without negotiating.  At any time, an entity can move to or from the Primoris contracts or their own negotiated rates and still benefit from the credentialing aspect of Primoris.  That being said, there are some plans that require you to take the Primoris rates to receive the delegated benefit of the Primoris contracts.  Delegated contracts allow Primoris to add a provider to the health plans much faster than the traditional method of sending an application to each health plan.  For Non-Delegated health plans, Primoris will still process an application but the provider will have to wait for the health plan to complete their verification and committee process rather than it being done by Primoris. 

The list below shows the current health plans that Primoris participates with.

Aetna/Coventry/First Health

Blue Advantage PPO

Blue Choice PPO

Blue Plan 65 Select

Blue Preferred PPO

Blue Lincs HMO

Blue Traditional

Caring Program

Blue Medicare Advantage HMO

Blue Medicare Advantage PPO

Evolutions Health

Fortified Provider Network

Global Health/Generations

Galaxy Health

HealthSmart

Humana Choice

Humana Military/Tricare

MultiPlan/PHCS/Beech Street

OK Health Network

Prime Health

United Health Care

USA Managed Care