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Third-Party Payer Contracting

Methodist Health Partners provides third-party payer contracting services to members of MHP as a messenger model PHO.
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Methodist Health Partners (MHP) contracting services include reviewing initial contracts terms and negotiating renewal contract terms. Each physician is given the opportunity to accept, reject, or counter-offer contract and reimbursement terms.

MHP is committed to assisting our providers succeed in value-based contracting by aligning payer reimbursement and incentives to the delivery of high quality, evidence-based medicine to our patients.  MHP supports a data driven approach to population health by facilitating and deploying internal resources, payer reporting and the expertise of our ACO partner Nebraska Health Network. 

Contracted Payers

Methodist Health Partners has contracted with the following payers to provide services to its members, employees, or insured:

Aetna

Commercial Aetna
Aetna HPN NHN
Aetna Signature Administrators
Aetna Behavioral Health
First Health
Meritain
Work Comp

Medicare Advantage
Aetna Medicare Elite (PPO)
Aetna Medicare Premier (HMO)
Aetna Medicare Premier (PPO)

Alliance NHN - First Choice Health TPA

Alliance Narrow Network

Ambetter by NE Total Care

Commercial Marketplace

Amerigroup (Wellpoint)

IA Medicaid

BCBSNE

Commercial
NEtwork Blue
Select Blue Choice
Premier Select Blue Choice

Commercial Marketplace
NEtwork Blue Heartland Blue
Premier Select Blue Choice Heartland Blue

Medicare Advantage
MA Core (HMO)
MA Choice (HMO-POS)
MA Access (PPO)

Consociate Health

Commercial PPO

Elite Choice

Commercial PPO
Narrow Network

First Choice Health

Commercial
Alliance narrow network

Humana

Commercial
Choice Care

Medicare Advantage
Humana Gold Plus (HMO)
Humana Choice (PPO)
Humana Honor (PPO)

Healthsmart

Commercial PPO
Work Comp

Iowa Total Care

IA Medicaid

MEDICA

Does not include behavioral health

Commercial/Marketplace
Insure (broad network)
Elevate (narrow network)
Medica Choice National (broad PPO network)

Medicare
Medica Advantage Solution (MA)
Medica Prime Solution (Medicare Cost)

Midlands Choice

Commercial PPO
Includes Cigna
Includes Oscar

Molina IA

IA Medicaid
Medicare Advantage

Molina NE

NE Medicaid

Multi Plan

Commercial PPO

NE Furniture Mart/Centivo

Commercial PPO

NE Total Care

NE Medicaid

NX Health dba Valenz Access

Commercial PPO

O’Hara Workers’ Comp

Work Comp

Oscar Health

Commercial Marketplace

United Healthcare

Does not include behavioral health

Commercial
UHC
Nexus ACO
UMR
John Deere (does NOT include JD Premier)
Allsavers

Medicare Advantage
AARP MA HMO-POS
AARP MA Choice PPO
AARP MA Patriot PPO

UHC Special Needs Plan
Dual Complete

NE Medicaid
Community Plan

UHC Optum VA CCN

Veterans Administration

Wellcare by Nebraska Total Care

Medicare Advantage

Wellmark

 Payer ID 88848

Commercial
PPO (Blue Card Program)

Classic Blue
Alliance Select
Wellmark Blue PPO

HMO (IA Providers only)
Blue Access
Blue Choice
Blue Advantage
Wellmark Blue HMO
IA Hawk-i

Medicare Advantage
Blue MA HMO
Blue MA PPO
Blue MA Enhanced PPO

Wellpoint (fka Amerigroup)

IA Medicaid
Medicare Advantage

Contracted Payers
Methodist Health Partners has contracted with various payers to provide services to its members, employees or insured.
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Our experienced team provides value-based payer contracting, credentialing, and provider relations services to Methodist Health Partners providers.