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Services List

Tower Health PPO (THPPO), a Preferred Provider Organization (PPO), service area includes Berks, Upper Bucks, Carbon, Northern Lancaster, Montgomery, Northampton, and Schuylkill counties. Through relationships with Third-Party Administrators (TPA's), insurance carriers, and insurance brokers, employer groups can access our valuable services encompassing: medical and case management; a comprehensive network of credentialed physician, hospitals, and ancillary providers.

Services Overview

Provider Network

Our provider network gives members access to over 3700 physicians, hospitals, medical equipment suppliers, and home and healthcare agencies. Our network of providers delivers healthcare services at negotiated rates and are credentialed based on NCQA standards. In-network referrals are not required, allowing members freedom of choice in their healthcare options.

Provider Discounts

Our provider discounts are very competitive. Participating providers are contracted to accept THPPO's fee schedule as the total payment for any covered medical services, and are not permitted to balance bill the patient to collect the difference, unless the plan applies a deductible, co-payment or co-insurance.

Medicus, A Health & Lifestyle Management Company

The medical management arm of THPPO, closely monitors the medical necessity and appropriateness of treatment for our members. Reviews are conducted prospectively by nurse case managers who use medical resources and evidence based guidelines. Medicus' goal is to provide high quality, cost efficient healthcare for its members.