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Frequently Asked Questions  

What is First Health?
First Health is a national managed care organization that provides comprehensive, cost-effective managed care services for group health plans, including one of the nation’s largest PPO networks. The First Health Network is the PPO of choice for TPAs, insurance carriers and other payors looking for quality, affordable health care.

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Is the First Health Network national?
Yes. The First Health Network serves more than 4 million people across the country, with more than 490,000 participating physicians, hospitals and other health care providers in all 50 states plus the District of Columbia.

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What types of services does First Health offer to insurance companies and TPAs?
In addition to the First Health Network, our portfolio of services includes flexible claims repricing; clinical management that offers traditional utilization review and early medical assessment; medical case management; a proprietary non-network fee schedule; and CDN—Community Dental NetworkSM.

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How do I find a First Health Network provider?
Currently, the most convenient way to find a doctor, hospital or other health care service provider participating in the First Health Network is by searching our electronic directory. The electronic directory includes the most detailed provider information available and is updated daily. You can also call us for assistance in locating a provider, 24 hours a day, at 1-888-685-7774.

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Why should I use a First Health Network provider?
Under your group health plan, you are free to decide whether to use a First Health provider, but there are many advantages to doing so:

  • They will file health insurance claims for you.
  • They will collect only patient co-payments, not the full amount of the charges.
  • Their services will most likely cost you less because of our contract rates with them, and in some cases, because your health plan pays higher benefits for using network providers.

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Can I nominate a provider for the First Health Network?
Yes. If you are a client, please contact your account manager to discuss the nomination process. If you are a member, you may complete our online provider nomination form, or obtain one from your employer or health plan administrator.

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How does First Health channel patients to its network?
We encourage strong benefit plans that direct or channel participants to First Health Network providers within state-specific guidelines for directing care. Increasing network penetration means health care cost savings for payors and members. Our electronic directory is the most convenient way for members to locate a provider. Other channeling tools include ID cards, paycheck stuffers and early identification of high-cost members through early medical assessment.

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How can I get more information about the First Health Network?
If you would like to obtain marketing materials or speak to a sales representative, you may contact us via this website or call us at 1-800-247-2898.

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