3750 N.W. 87th Avenue, Suite #500 - Miami, FL

PNS Provides Creative Solutions for Today's Challenging Healthcare Market

By the Numbers

Members Under Management
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Unique Specialist Locations
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Years of Success
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Trusted partner delivering its clients the benefit of over 20 years of industry experience with a proven track record of success!

Value-Based Speciality Organization

Provider Network Solutions (PNS) is a market leader and innovator that partners with a Third-Party Administrator and an NCQA Accredited Healthcare Utilization Management organization aligning Health Plans, Primary Care Physicians, and Specialists.

Our Solutions

Delegated Services

Our team is here for you every step of the way. With years of experience and training, we are fully prepared to provide exceptional quality care.

Claims Processing

A fully licensed and integrated TPA system that handles Medicare, Medicaid, Healthy Kids, CMS T19 & T21 & Commercial line of business

Compliance

A strong focus on compliance oversight of all CMS Medicare, Medicaid and Health Plans requirements

Network Development

Ensures all state and federal guidelines for member access, accessibility, and provider ratio count are met

Provider Relations

Works in close partnership with Health Plan partners, providers, and the community's needs to create personalized specialty care solutions for all members

Utilization Management

Ensures the delivery of health care is appropriate, cost-effective, and of the highest quality under the NCQA Accredited guidelines

Credentialing Intake

Aligned with NCQA guidelines and our Health Plan partners' credentialing requirements, we alleviate initiating the credentialing process for unqualified providers

Lines of Business

Medicare

Medicare

We service and support Medicare Advantage, Traditional Medicare and eligible Medicare members who belong to an ACO. 

Medicaid

We service and support the Medicaid Managed Care population across the State of Florida, including SMMC Specialty Plans.

Healthy Kids

We service and support the Florida Healthy Kids population across the State of Florida.

Commercial

We service and support many of our health plan partners whom have Commercial products, such as, individual, employer and self-funded.

Exchange / ACA / Marketplace

We service and support many of our health plan partners whom have Exchange / ACA / Marketplace products. 

Our Specialties

  • Diagnosis and treatment of seasonal and environmental allergies
  • Comprehensive allergy testing and evaluation
  • Asthma and respiratory allergy management
  • Food allergy assessment and treatment plans
  • Personalized care to improve quality of life
  • Comprehensive heart health evaluations
  • Diagnosis and management of cardiovascular conditions
  • Preventive care and risk factor assessment
  • Treatment plans for hypertension and heart disease
  • Ongoing monitoring for optimal cardiac wellness
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  • General Dermatology
  • Mohs and Dermatologic Surgery
  • Pediatric Dermatology
  • Evaluation and treatment of neurological disorders
  • Care for headaches, migraines, and seizure disorders
  • Diagnosis of nerve and muscle conditions
  • Management of stroke-related complications
  • Personalized neurological care and monitoring
  • Comprehensive kidney health assessments
  • Diagnosis and treatment of chronic kidney disease
  • Management of hypertension related to kidney function
  • Care for electrolyte and fluid balance disorders
  • Coordination of dialysis and advanced kidney care services
  • Sports Medicine
  • Hand Surgery
  • Pediatric Orthopedics
  • Spine Injuries
  • Foot and Ankle Orthopedics
  • Joint Replacement
  • Trauma Surgery
  • Musculoskeletal Disorders
  • General Orthopedics
  • Reconstruction Surgery
  • Specialized care for cancer and blood disorders
  • Comprehensive diagnostic evaluations and treatment planning
  • Management of anemia, clotting disorders, and hematologic conditions
  • Coordination of chemotherapy and supportive care services
  • Patient-centered treatment and long-term follow-up care
  • Anesthesiology
  • Neurology
  • Physiatry
  • Physical Medicine and Rehabilitation
  • Interventional Pain Medicine
  • Podiatric Orthopedics
  • Podiatric Primary Care
  • Podiatric Sports Medicine
  • Podiatric Surgery
  • Podopedriatics
  • Wound Care and Management
  • Diagnosis and treatment of lung and respiratory conditions
  • Comprehensive asthma and COPD management
  • Evaluation of chronic cough and breathing difficulties
  • Sleep-related breathing disorder assessments
  • Personalized treatment plans for improved respiratory health

Stay Tuned…

Health Plan Partners

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Cigna
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Florida Community Care
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Simply Healthcare
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Cigna
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Florida Community Care
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Simply Healthcare
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