Payers FAQs
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Here are answers to some frequently asked questions about PTPN. If you have any further questions, contact us at info@ptpn.com.

Why would I want to use PTPN providers?
Is there a cost to access PTPN’s providers?
Does PTPN take a percentage of the reimbursement dollar?
Can I choose the service area I want?
Can I delegate credentialing to PTPN?
Does PTPN have quality assurance, utilization management or case management programs?
What is the PTPN Outcomes Program and how does it help me?
Does PTPN accept any willing provider?
Once I am contracted, will you come and speak to my staff about PTPN?
Does PTPN perform any ombudsman functions?
How does PTPN keep us updated on provider changes?


Why would I want to use PTPN providers?
PTPN was founded in the belief that the professional expertise and personal commitment of the private practitioner deliver the best value and the highest level of service to both patients and payers. Our financial incentives are aligned for your benefit because we don’t have such conflicts of interest in our ownership as corporate or physician ownership that would drive up costs and utilization. And the PTPN Outcomes Program gives you unprecedented data about provider outcomes and treatment results.

Is there a cost to access PTPN’s providers?
There are no PTPN access fees. PTPN revenue is derived from annual provider dues.

Does PTPN take a percentage of the reimbursement dollar?
No, PTPN charges its providers a flat annual fee. In some states this fee may be related to business volume. PTPN contractors pay our providers directly, so the money does not pass through our office.

Can I choose the service area I want?
Absolutely. You can contract with PTPN locally, regionally or nationally.

Can I delegate credentialing to PTPN?
Yes! PTPN’s credentialing program, which exceeds NCQA standards, has passed every on-site audit. PTPN is delegated credentialing for 98% of our payers nationally.

Does PTPN have quality assurance, utilization management or case management programs?
Yes. We have a comprehensive Quality Assurance Program developed and refined since 1985.

What is the PTPN Outcomes Program and how does it help me?
The PTPN Outcomes Program lets you compare the performance of PTPN providers to national benchmarks, giving you the data you need to monitor network quality.

Does PTPN accept any willing provider?
No. PTPN has strict membership standards, including independent ownership, continuing education, Medicare certification, ratio of aides and assistants to therapists, and geographic requirements. Only after meeting PTPN’s unique criteria, and passing both an on-site review and primary source verifications, are new providers enrolled.

Once I am contracted, will you come and speak to my staff about PTPN?
We are happy to do a PTPN in-service. It usually takes no more than 30 minutes. Call your PTPN contact for more information.

Does PTPN perform any ombudsman functions?
Certainly! PTPN often acts as the intermediary between providers and payers on claims issues, being listed as a preferred provider, quality issues and more.

How does PTPN keep us updated on provider changes?
PTPN sends out regular notifications to contractors on new providers, terminated providers, address changes, etc.