Contracts
Highlands Physicians, Inc. members benefit significantly through our IPA contract negotiations and support. Together, we have more leverage and attraction for larger payouts and better quality for patients from Medicare, Medicaid, and private insurance plans. Learn more about our contracting support and how it can help your medical practice serving Northeast Tennessee and Southwest Virginia.
Contracting Support
Our team handles your contracting tasks and worries with EXCELLENCE knowing they are critical to your overall SUCCESS!
HPHN Contracts
Highlands Physicians has a variety of contracts to offer our members. These consist of MCO contracts, direct employers group contracts, and value-based care/gain-share contracts. We have over one hundred offices, many with less than five physicians operating in rural areas. Because HPI is value-based care driven, in 2014 we helped design and support the first physician-led ACO in our region. The ACO generated savings of over $50,000,000.
If you are interested in being a part of an ACO and want more information about the contracts we offer, please reach out to Provider Relations at ProviderRelations@HighlandsPhysicians.com.
- Aetna (Open Choice/Managed Choice/Elect Choice/EAP Amendment applicable to Behavioral Health Providers)
- Aetna Better Health of Virginia (formerly Coventry Cares of Virginia) – VA Medicaid – does not recognize Physician Assistants
- Amerigroup (Wellpoint) Fee for Service
- AmeraNet
- American PPO
- Apex Community Plan
- Beech Street (Group Health/Auto Medical/Premier/Providian)
- Beech Street (Workers’ Comp)
- Coventry National Network Group Health (formerly First Health Group Health)
- Coventry National Network Workers Comp (formerly First Health Workers Comp)
- Coventry Health Care of Virginia – “Self-Insured” ONLY (formerly Southern Health)
- Corvel (Workers’ Comp)
- Equality Health (Amerigroup/Wellpoint Incentive Overlay) – PCP Only
- Evolutions PPO
- Galaxy
- Humana Choice Care PPO (Commercial ONLY)
- Humana PFFS (Private Fee For Service)
- Humana P4P (Medicare)
- Multiplan – does not include PHCS
- NovaNet – does not recognize Mid-Level providers other than PT’s & OT’s
- Partners Direct Health
- Prime Health Services, Inc. (Group Health)
- Provider Select, Inc.
- SelectNet Plus
- Sentara Health-Medicaid
- Sentara Health-Medicare
- The Initial Group (PPO – Initial Health Alliance & POS – Initial Plus)
- USA (EPO)
- USA (PPO)
- USA (Workers’ Comp & Injury Network)
- WellCare (Medicare Advantage Plan) – formerly known as Windsor Health Plan
- Network B (Automatic contracts): Pittston Preferred
- Network S: The United Company Underwriters Service Corporation
- Virginia Health Network dba MedCost Virginia:
Dickenson County Employees – Medcost - Virginia Health Network dba MedCost Virginia: Scott County School Board – Medcost
A community-owned health plan changes status quo healthcare, creating products that are local and independent.
At Apex, we’re revolutionizing healthcare by putting the power back into the hands of our community. Founded in 2022 in response to the growing concerns of provider members regarding skyrocketing healthcare costs, Apex is dedicated to offering local, independent solutions that prioritize affordability and accessibility.
As with all initiatives developed by HPI, this program is designed with independent physicians in mind. There are several ways to participate in the program, you can participate as a Tier 1 provider, utilize Apex as your participating insured group or both. The plan is designed to bring high-quality, low-cost care to our community and members while financially benefiting the physician members of HPI.
Our approach is simple yet innovative. By untangling the complexities of traditional healthcare models, we’ve crafted a plan that slashes costs and streamlines care delivery. HPI has unbundled the insurance offering. We have utilized local and/or independent Third-Party Administrators, Stop Loss Gap Carriers and Pharmacy Benefits Management. Where possible we have cut out unnecessary middlemen to drive down costs and improve efficiency. By partnering with local or independent suppliers, we ensure transparency and affordability in prescription drug costs.
Apex is committed to breaking down barriers to care and making healthcare more accessible for everyone. That’s why our plan features a groundbreaking design:
- Zero Copay
- Zero Deductible
- Zero Cost on Generic Prescriptions: when you see a Tier 1 provider.
Join us in reshaping the future of healthcare.
Experience the difference with Apex: Your Community-Owned Health Plan!
COMING SOON
Send Us a Message
Join Us
Contact Highlands Physicians, Inc. today to learn more about partnering with us and enjoying all the benefits our membership offers. Call our office at 423-392-1920 or complete the contact form for more information.
