Networks

MedCost Benefit Services offers one of the largest, most effective PPO networks in the Carolinas, MedCost Preferred, which is comprised of more than 10,500 primary care physicians, 20,500 specialists, and over 840 hospitals/facilities/ancillary providers. With over 25 years of experience in hospital and physician contracting, we work hard to provide broad access and substantial savings to our members while ensuring a continuum of quality care.

Provider Choice—The MedCost Preferred network includes most providers in North and South Carolina. This means that employers who choose MedCost Preferred experience minimal disruption for their employees due to a physician or hospital not being a part of the network.

Substantial Savings—On average, MedCost Preferred customers save $63 for every $1 spent to access the network.

Credentialing—MedCost Preferred physicians and hospitals are required to meet strict credentialing criteria. This includes education, certification, licensing, hospital privileges, practice history, criminal history, malpractice history, and 24-hour practice coverage for physicians. Hospitals are compared to surrounding hospitals relative to reputation, range of services, cost-effectiveness, and location. MedCost has been URAC accredited in provider credentialing since 2000.

Provider Review—MedCost has a team focused exclusively on physician billing and utilization practices of MedCost Preferred providers. Led by one of the most respected physicians in the region, this team profiles providers by specialty to identify any who have unusual billing practices or abnormally high utilization. These reviews are part of our quality initiatives and our long-term goal of having and maintaining the highest-quality, most cost-effective network of providers.

No Referrals—Patients have open access to physicians across a broad range of medical specialties.

Ancillary Services—As patient care continues to shift from the hospital setting to other settings, the MedCost Preferred network has broadened to include all types of ancillary services such as home health, hospice care, durable medical equipment, home infusion therapy services, prosthetics, and orthotics.

Transplants—MedCost Preferred offers access to all tertiary hospitals in North and South Carolina, resulting in significant savings on high-cost transplant procedures.

To meet the needs of our clients outside the Carolinas, MedCost maintains positive relationships with both national and regional networks.

If you are a current member and know your provider network, go to Provider Search to find a provider in your area. If you do not know your provider network, go to Member login to search your specific network.