DirectCare America, Inc. (DCA) is a member of The Chandler Group of Companies. Founded in 1995, DCA has quickly become one of the largest independent healthcare PPO networks in the Midwest as measured by number of hospital providers, physician providers and enrollees. DCA provides healthcare delivery to nearly one million individuals with its vast network of more than 173,000 physicians and 1,700 hospitals from New York to Illinois and from Wisconsin to Virginia.
Our directly contracted providers are invited to participate in the network upon completion a comprehensive credentialing process. Hospital and physician credentialing is consistent with NCQA standards. Physician credentialing is performed every three years.
Our client base consists of the following types of organizations:
• Third Party Administrators
• Insurance Companies
• Taft-Hartley Funds
• School Districts
• Multiple Employer Groups
• Self-Insured Employers
DCA began contracting efforts in northeast Ohio and has expanded the network to Indiana, Kentucky, Michigan, West Virginia, Wisconsin, Illinois, New York, Pennsylvania, Virginia, New Jersey, Maryland and Delaware.
Fees are charged on a per employee per month basis (PEPM) or a percentage of savings and fees will vary according to selection of services.
DCA provides flexibility in all phases of claim re-pricing including:
• On-site re-pricing
• EDI capabilities
• Internet alternatives
• System download
• Dial-in modem
The most current directories are available on-line. Simply visit www.directcareamerica.com and select “Provider Directory” to obtain the most current provider information.
DCA has national coverage through various PPO affiliate partners for employees residing outside the service area.
National hospital and physician access reports are available through our GEOAccess reporting capabilities. The Chandler Group’s in-house data analysis system, ProClaim, produces a variety of customized reports by geographic region, by client, by provider and/or by patient.
DCA engages a medical director, peer review board and registered nurses to oversee the company’s cost containment efforts.
Our staff of experienced and friendly professionals can be reached by calling 800.266.5896 between 8:30 am – 5:00 pm Eastern Standard Time. Client Service Representatives can be assigned a specific client.