Provider FAQ

How do I get started?

Credentialing is the first step to verify experience, then we meet to discuss rates and terms to offer our members, establish your web page profile, join the PPC Co-op and you’re ready to accept members!

What do you need for the credentialing process?

We’ll require your resume, cme credits, NPI number, medical malpractice insurance, Oregon’s standard application, a copy of your license and school diploma and a W-9.  See Credentialing Agreement

What services are covered by PPC Providers?

Annual contracts for medical services typically include: preventative care, annual exams and physicals, and management of chronic conditions. Any additional services needed are paid directly to providers at the time of service at reduced cash rates. Members can choose multiple providers to contract with yearly or pay the established drop-in rates at time of service.

What about other services like labs, imaging, specialists or hospitalization?

PPC membership includes $0 copay screenings and lab tests covered at 100% through our exclusive partnership with Quest Diagnostics. In addition, we have contracted with other local lab & imaging companies that offer discounted cash rates for our members. Other services are covered by our advocacy benefit which can also help reduce out of pocket costs.

How do I figure out what to charge?

This is a customizable health care plan based on what members can afford on a monthly basis and what kind of provider they would like to choose. We’ll work with you on an individual basis to determine your rates & terms. Typically it is a discount off cash rates comparable to Medicare rates. See our website for example provider rates.

How do I get paid?

Monthly capitation checks are sent to all providers who have active members contracted with them. Checks are mailed at the end of each month along with the list of all current paid members for that month.

How do I get patient members?

We are a community based organization and building co-op membership is a team effort. PPC marketing efforts range from social media, community events, poster marketing, provider education to their patients and good old fashioned Word of Mouth marketing!

We encourage our providers to participate in all our co-op building efforts. Introduce yourself to the community by attending our regular membership meetings. Put up posters, create marketing videos & educational materials to share on our website & newsletter. Turn those uninsured patients into a regular source of income & encourage them to join!

Why should I join the PPC?

To establish a direct payment plan with the patient that eliminates the need for filing insurance claims. To have an advocate in the community who promotes your practice. To eliminate the need to go through a third party for reimbursement. To give your employees access to affordable benefits. There are no exclusions for pre-existing conditions or waiting periods to join the co-op.

How do I verify a member’s eligibility?

To verify a patient’s membership status, contact member services at 1-866-549-4199.