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Provider Frequently Asked Questions (FAQs)

  • What is the background of PPOplus?

    Originally established in 1988 by leading regional community hospitals, PPOplus is the region’s premier Preferred Provider Organization (PPO). Today PPOplus is a privately held corporation, not owned by physicians, hospitals or insurance carriers. Led by a team of experienced PPO executives and now one of the network solutions offered by Zelis, PPOplus is a full-service PPO that delivers quality healthcare networks and administrative services to insurance carriers, third party administrators and self-funded employer groups.

  • What service area does the PPOplus network cover?

    PPOplus has developed a significant regional presence with statewide coverage in Louisiana, Mississippi, Arkansas and extended coverage into western Tennessee. With over 30,000 medical providers, PPOplus offers its clients choice, convenience, and appropriate geographic coverage.

  • What are the advantages of being a PPOplus Preferred Provider?

    • PPOplus enforces timely claims payment for its providers.
    • PPOplus members receive financial incentives for accessing network providers through the benefit plans design.
    • Participating providers are listed in online and printed Provider Directories, which are distributed to each member.
    • Numerous hospitals and health systems in the region are currently participating providers with PPOplus, making it easy to find preferred providers when you need to direct a patient elsewhere for care.
    • Easy web access to online provider resources including online directories and update forms.
    • A dedicated provider services team available to assist you and your staff with any questions you may have about the program including scheduling an on-site orientation for your office.
    • Receive fewer requests for single case agreements through network participation.

  • How many members are accessing the PPOplus network?

    With thousands of members currently accessing PPOplus' regional network, your practice or facility may experience increased patient volume following network enrollment and participation.

  • Does the PPOplus logo appear on the patient’s ID card?

    Yes, a PPOplus logo will appear on the patient’s ID card making it easy to identify PPOplus members.

  • Does PPOplus accept claims filed electronically?

    Yes, with a strong focus on Provider Service and in an effort to promote ease of administration for its provider partners, PPOplus has made a commitment to advanced state-of-the-art technology. We have streamlined the claims process and shortened the turnaround time by offering electronic claims filing to our providers. PPOplus' electronic payer number is 36335.

  • What differentiates PPOplus in the marketplace?

    PPOplus’ mission is to provide a network that is more responsive to its clients and providers and which better fits the needs of today’s employers.

  • How do I join the PPOplus Network?

    PPOplus maintains an open-panel network. Therefore, we welcome all providers who meet our credentialing criteria to join. PPOplus’ credentialing program is based upon National credentialing standards.

    In order to join, please email providercontact@zelis.com to request a network enrollment packet or contact the PPOplus Provider Services Department at 1-888-965-7718 to request an application for participation. After completing the application, please return it either securely electronically to providercontact@zelis.com or mail to:

    Zelis
    PPOplus Provider Services Department
    Two Concourse Parkway
    Suite 300
    Atlanta, GA 30328

  • Where should claims be sent?

    For all PPOplus members, paper claims should be mailed to PPOplus’ post office box:

    PPOplus, LLC
    P.O. Box 247
    Alpharetta, GA 30009

    Electronic Mail Address: Payer ID# 36335

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