PrimeCare Administrators, Inc. (PrimeCare), is a service company founded under the premise that its management can provide the most accessible, efficient, cost effective and valuable dental plan administration in the administrative services marketplace.
PrimeCare is duly licensed by the Nevada Division of Insurance as a third party administrator and offers its services to self-insured employers, ERISA plans, Taft-Hartley trusts and government-sponsored dental benefit plans. PrimeCare’s expansive preferred provider network of skilled and credentialed dental professionals, its unique and proprietary compensation methodologies and its creative plan management solutions establish a new competitive level in the marketplace.
PrimeCare services, capabilities and enterprise systems include the following:
- Plan Benefit Consulting
- Design and Development of Dental Insurance Plans
- Policy and Certificate Issuance
- Dental Health Insurance Administration
- Dental Claims Administration
- Customer Service
- Dental PPO Network
- Administration of Dental Preferred Provider Plans
- Specialty Care Cost Containment (Endodontic, Oral Surgery)
- Quality Review, Quality Assurance and Quality Audit
- Dental Services Utilization Review
- Dental Disease Management and Coordinated Care
- Employee Communication and Fulfillment Services
- Reinsurance Accounting Administration
- Premium Administration
- Billing Services; Direct bill, Electronic, Group and Individual
- Electronic Processing of Dental Claims and Payment Data
- Enrollment and Eligibility Services
- Commission Payment; Check and EFT
- COBRA Administration
PrimeCare utilizes a seasoned team of claims processing and claims management staff who, along with management, have broad experience in the dental insurance industry on both a fully insured and self- insured basis.
PrimeCare operates on a customized, state-of-the-art system for the adjudication of claims and delivery of customer service. This secure system provides PrimeCare with the ability to process the vast majority of its claims without human intervention, from automated electronic entry through issue of payment. Over 2,000 algorithms challenge each claim to verify eligibility, provider status, appropriateness of care, compliance with plan design, and applicability of exclusions and limitations. Any outliers, as well as a small percentage for quality control, are flagged for human review. Our Customer Service Center staff and care coordinators are empowered to resolve over 90% of employee/member inquiries during the first call. They have the ability to assist callers on eligibility issues, circumstance changes, payment of premium, claims history and prior-authorization processing (if required). The PrimeCare system produces detailed and complex reports to management for real time oversight in all areas of operation toward the goal of enhancing the overall service quality and value to clients.
The combined experience of the PrimeCare leadership team in the dental insurance and administrative services marketplace exceeds 100 years and the Team possesses a demonstrated record of innovation in delivering and improving access to affordable and quality dental care and dental administrative services throughout the U.S.
JOIN OUR NETWORK
As a participating provider with PrimeCare Administrators, you gain privileged access to the employees of key employer groups, while working with a team of dental professionals, who work side by side with you, to ensure dentists are receiving the most competitive reimbursement for the care you provide to your patients.
To request an application to become a participating provider with PrimeCare Administrators, select JOIN NOW or you may speak to a Professional Networks representative by calling us at (702) 724-9080.
If you have already received an application packet and would like to return it to us, please mail to:
P.O. Box 82067
Las Vegas, NV 89180