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PruittHealth Premier (HMO SNP) and PruittHealth Premier D-SNP (HMO D-SNP) firmly believes that our success as a health plan hinges on our participating Providers. And we are committed to simplifying the administration of health insurance so our providers can devote their attention to providing high-quality health care.

We are always available if questions arise, and we collaborate with our Providers to help ensure the efficient delivery of superior care to our members.

EZ-NET Provider Portal Access

If you are a current PruittHealth Premier provider, please log-in to use the EZ-NET Provider Portal. Or, click here to submit a claim.

The PruittHealth Premier EZ NET Provider Portal offers Providers secure, web-based access to healthcare information, including claims, eligibility, and benefits. And, it does so in a secure manner which protects the HIPAA privacy of our Members.

The EZ-NET Provider Portal allows Providers access to:

  • Submit claims into the EZ CAP system
  • Inquire on authorization status
  • Verify Member eligibility
  • View Member authorization history
  • Check the status of claims/encounter information
  • Look up procedure codes, diagnosis codes, and other general reference information

New User Registration

Providers can register a new user through the New User Registration link on the EZ-NET Provider Portal.

An example of the pre-login page is shown below.

After registering as a New User, you will receive a confirmation email message asking you to verify your account. The email will be sent to the email address you provided. To confirm your account, click on the confirmation link provided in the email.

Once the EZ-CAP Administrator verifies your account in EZ-CAP, you will be notified that your EZ-NET login is fully activated; and you will receive directions on how to access the EZ-NET Provider Portal.

Retrieve Password / Reset Password / Retrieve Username

For a forgotten username or password, Providers should click on “Forgot Username/Password” on the EZ-NET Provider Portal. An example of the pre-login page is shown below.

You will be taken to a new screen where you will enter your User Name and Email Address to Retrieve Your Password.

Click “Clear” to clear all entries or click “Next” to submit request to Reset Your Password.

Click on the hyperlink “Forgot your Username” to retrieve your username. (Note – this will only work if the Password Recovery Question and Answer Setup has been created.)

If you are unable to do password recovery, send a password reset request to [email protected]. Make sure you include your username so that we can locate your EZ-NET user account. You can also call Plan Toll Free Number option 4 for assistance on password resets and status of claims submission.


Claims and remittance advices can be submitted and retrieved electronically through your existing clearinghouse or billing company.

  • If you do not use a clearinghouse or billing company, you can use the EZ-NET Provider Portal for online submission.
  • Providers can submit claims through their clearinghouse and receive electronic remits. For claims questions, contact the Plan at 1-844-205-7244 (TTY 711),
    option 4. For EZ-Net support contact [email protected]

For ease of processing payment, electronic claims are preferred; however, if you are unable to send us a claim electronically, please mail it to:

PruittHealth Premier
PO Box 908
Addison, TX 75001-0908

SSI Claimsnet Customer Support

For Prescribers & Pharmacies

PruittHealth Premier provides Medicare Part D prescription drug coverage through our partner Navitus Health Solutions.

Navitus Health Solutions is a full-service pharmacy benefit management company committed to lowering drug costs, improving health, and providing superior customer service in a manner that instills trust and confidence.

For Prescribers:

  • Access Formulary and Prior Authorization Forms at
    • Select “Prescribers” and click on “Prior Authorization”
    • Enter your NPI number and State to access the prescriber portal
  • Navitus Health Solutions Pharmacy Helpdesk
    • Phone number: 1-866-270-3877
    • TTY phone number: 711
  • Refer to the Prescription Drug Benefit page for formulary, prior authorization criteria, and step therapy criteria

For Pharmacies:

  • Access payer sheets and other information at
    • Select “Pharmacies” and click “Pharmacies Login”
    • Enter your NPI number and NCPDP number to access the pharmacy portal
  • Navitus Health Solutions Pharmacy Helpdesk
    • Phone number: 1-866-270-3877
    • TTY phone number: 711
  • Refer to the Prescription Drug Benefit page for formulary, prior authorization criteria, and step therapy criteria

Special Needs Plan (SNP) Model of Care & Training

At PruittHealth Premier, we specialize in improving health care and advancing a truly unique philosophy of care to meet the complex needs of the institutional Medicare beneficiary population, while simultaneously streamlining administrative functions for our Providers.

The PruittHealth Premier Model of Care focuses on providing a unique level of customized clinical care and services for our Members. As we help extend your care, our care model concentrates on addressing each Member’s full range of medical, functional, and behavioral health care needs in a coordinated and Member-centric manner. This means putting the Member’s preferences at the center of the care planning process and leveraging Provider resources to ensure every Member receives the services necessary to achieve their short- and long-term care goals.

Our model organizes best practices and industry innovations including:

  • The PruittHealth Premier Case Manager and primary care physician (PCP) care team Member-centric support;
  • A risk-assessment tool designed for a senior patient population;
  • A comprehensive history and physical assessment that generates an Individualized Care Plan (ICP);
  • A care management platform that helps identify needed preventive health/HEDIS services, ensures the use of evidence-based clinical guidelines, and facilitates care team communications for care coordination; and
  • Face-to-face Member and caregiver/family member interactions that identify Member care preferences and allow time for important care decision discussions and counseling.

It is important that all of our Providers are properly trained and informed about the Pruitt Health Premier Model of Care. Our top priority is making sure all of the providers in the PruittHealth Premier network meet the training and education needs of our Medicare beneficiary population. The purpose of the Model of Care Training (I-SNP) and Model of Care Training (D-SNP) are to comply with the statutory requirement of the Centers for Medicare and Medicaid Services (CMS), that all Special Needs Plans provide a general understanding of the requirements of the Model of Care. In addition, this will also help you to seamlessly serve Pruitt Health Premier Members, your patients.

Become a PruittHealth Premier Network Provider

PruittHealth Premier contracts with physicians, facilities and other allied providers to ensure we have an adequate provider network which is essential for the delivery of health care services to our members. All providers must be credentialed before they can be added to our network as a participating provider.

Why Partner with PruittHealth Premier:

  • From the beginning, physicians discover that PruittHealth Premier isn’t just another Medicare Advantage health plan.
  • We have a different philosophy, attitude and approach to caring for our Members.
  • Our emphasis is on encouraging proactive health care and offering programs and services that can make a difference in our Members/your patients’ quality of life.
  • We believe in providing our Members exceptional benefits and an abundance of attention.
  • And we believe PruittHealth Premier providers deserve the same.

For more information on becoming a PruittHealth Premier contracted provider, please contact Network Operations at 1-844-224-3659 or via email at:

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