PNS Provides Creative Solutions for Today's Challenging Healthcare Market

By the Numbers

0 M+
Members Under Management
0 +
Number of Specialists
0 +
Unique Specialist Locations
0 +
Years of Success
Trusted partner delivering its clients the benefit of over 20 years of industry experience with a proven track record of success!
medical provider and businessman shaking hands to work together ensuring best patient care by following NCQA Accredited Guidelines

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 that the delivery of health care is appropriate, cost-effective, and of high 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

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

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

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

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

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

Our Specialties

  • General Dermatology
  • Mohs and Dermatologic Surgery
  • Pediatric Dermatology
  • Sports Medicine
  • Hand Surgery
  • Pediatric Orthopedics
  • Spine Injuries
  • Foot and Ankle Orthopedics
  • Joint Replacement
  • Trauma Surgery
  • Musculoskeletal Disorders
  • General Orthopedics
  • Reconstruction Surgery
  • 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

Stay Tuned…

Health Plan Partners

Cigna
Florida Community Care
Simply Healthcare
WellCare