Paradigm Specialty Networks is a leader in managing the care of injured workers and works with some of the largest insurance companies, TPAs, and self-insured employers in the country. Paradigm Specialty Networks also refers patients resulting from automobile accidents and will soon refer general insurance patients. As an in-network provider, you’ll have the potential to see patients you might not otherwise have had access to. And because we are careful not to contract with specialists and facilities offering similar services in any given area, you can expect to see a marked increase in your workers’ compensation patient population almost immediately.
We recruit providers in the following specialties: interventional pain management; physiatry, anesthesiology; general orthopedics and all sub-specialties; orthopedic surgery; neurology; neurosurgery; physical therapy; occupational therapy; podiatry; chiropractic; acupuncture; ambulatory surgery centers.
We recruit providers in the following specialties: skilled nursing; assisted living; inpatient rehabilitation; outpatient rehabilitation; long-term acute care; traumatic brain injury; and home health.
We recruit highly specialized facilities and mental health professionals whose focus is in the treatment of mental disorders.
We recruit orthopedic surgeons and other orthopedic specialists, as well as neurologists and neurosurgeons.
Yes. Depending on the network, we contract with ambulatory surgery centers, hospitals, post-acute care facilities, and other focused healthcare organizations.
Send us an email and a provider specialist will get back with you ASAP.
During the onboarding process, you’ll be asked to submit the following credentialing information: your W-9; your commercial general liability insurance (slip & fall, not malpractice); and your CAQH (Council for Affordable Quality Healthcare, Inc.) number. If you do not use CAQH, you may instead submit your license, NPI Number, and CV.
No. When you work with Paradigm Specialty Networks, you’ll eliminate most of the negative issues in the typical process of treating workers’ compensation patients. Referred patients come to you already authorized for treatment. If new authorizations are needed (including additional treatments), we will handle that for you. Claims for Paradigm Specialty Networks referred patients are sent directly to us, and we guarantee that payment is made to you within your state’s prompt-pay guidelines, whether we get paid or not.
Paradigm Specialty Networks prides itself on its high-level of provider support, and we have a dedicated customer service department. Every provider in our network is also assigned a provider relations specialist when they enroll, and this specialist will help you with questions or anything you need to make your experience with Paradigm a good one.
Just email us and we’ll be happy to help.
You do. We are not in the business of making medical decisions for our providers. Providers are screened prior to acceptance into the network, and we count on them to deliver the outcomes our clients demand. Of course, if you need help with a case, we have a skilled team of health care professionals ready to assist. Note: Peer review may be mandated in specific jurisdictions.
Reconsideration requests for Specialty Networks may be submitted in a variety of ways:
For surgical implants: send us an email
For comprehensive pain and behavioral health: send us an email
For ortho & spine: mail to the address below:
Paradigm Specialty Networks
P.O. Box 2936
Milwaukee, WI 53201
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Reconsideration requests for Care at Home may be submitted in a variety of ways:
Through our provider portal
The preferred method for sending bills and reconsiderations for Care at Home services is via our provider portal https://portal.homecareconnect.com. To obtain access to the portal, visit the link and click on “Request Account.” Other options are also available, as noted below.
By email: medicalrecords-networks@paradigmcorp.com
By fax: (855) 625-9553
By mail:
Paradigm
4890 W. Kennedy Blvd., Suite 650
Tampa, FL 33609
Obtaining payment status
Payment status can be obtained via our provider portal https://portal.homecareconnect.com. To gain access to the portal, visit the link and click on “Request Account.” Your account access should be provided within 24 hours.
All Paradigm Specialty Networks providers are automatically enrolled in the ECHO Health Payment System, and all payments for submitted claims will be made using this system. You may also use ECHO to track your unpaid claims, as well as generate a variety of reports and other useful information. Click here to log in to ECHO.
Providers that have a change of ownership, credentialed personnel, or address(es) (including additions, deletions, and/or modifications) should email, call, or write Paradigm Specialty Networks within five business days to report the appropriate changes.
Email
For updates via a provider roster, email: accountsupport-networks@paradigmcorp.com
Call
If you don’t have a roster, need the current version, or just have general credentialing questions, call 844-424-1451. Credentialing is option 4. Follow the prompt for directing calls.
Written inquiries
Paradigm Specialty Networks
4890 W. Kennedy Blvd., Suite 650
Tampa FL 33609
Paradigm webinars are free of charge.
If you have a topic suggestion, please email us.
To receive invitations for Paradigm’s upcoming webinars click here, and we'll add you to the webinar notification list.
We offer CE credits for live webinars, which can include CEU adjuster credits, CE for national nurse credit, and Commission for Case Manager Certification (CCMC) national credit. Please view the webinar detail page to see the specific credit that is approved. If CEU adjuster credits are provided, the webinar details page will list the specific states that have been approved. To request course materials for other accreditation you are seeking, please email us.
You must attend the live webinar to obtain the approved CE credit. To receive credit, you will be asked to complete an evaluation immediately after the live event or you will be emailed a credit submission link and evaluation post-event. You may also be asked to answer polling questions during the live event. If there are polling questions, you must answer the questions to receive credit. During each live webinar, Paradigm will clearly state the credits being offered and how to obtain credit. If you have any questions regarding how to receive credit, please email us.
Please email us if you have any questions or issues with receiving credit.
This link leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
