PPO Network Design Criteria
The purpose of this product is to allow access to a nationwide network of physicians for members who need that service. Therefore, except for organizations and providers within the Mercyhealth service area, i.e. SSM Health (formerly Dean Health System/St. Mary’s Hospital and Monroe Clinic, OSF Healthcare System, Swedish American Health System, Beloit Health System and Aurora physicians and facilities, the whole First Health network is included. First Health is a national network that uses credentialing standards that meet nationally recognized credentialing standards in determining which providers will be included in its network. However, given the size of the network neither First Health nor MercyCare utilizes member experiences, quality measures nor cost-related measures to determine which practitioners or facilities can join the network.
PPO Network Design Criteria
The purpose of this product is to allow access to a nationwide network of physicians for members who need that service. Therefore, except for organizations and providers within the Mercyhealth service area, i.e. SSM Health (formerly Dean Health System/St. Mary’s Hospital and Monroe Clinic, OSF Healthcare System, Swedish American Health System, Beloit Health System and Aurora physicians and facilities, the whole First Health network is included. First Health is a national network that uses credentialing standards that meet nationally recognized credentialing standards in determining which providers will be included in its network. However, given the size of the network neither First Health nor MercyCare utilizes member experiences, quality measures nor cost-related measures to determine which practitioners or facilities can join the network.
