Provider Network Solutions of Puerto Rico
- Company typePrivate
- Founded-
- HeadquartersSan Juan, United States
- Headcount101–250
- GTM typeB2B
- OfferingServices
Provider Network Solutions of Puerto Rico firmographics
Firmographics- Name
- Provider Network Solutions of Puerto Rico
- Legal name
- Provider Network Solutions
- Website
- https://pns-pr.com
- Company type
- Private
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Ownership category
- akta.pro rank
Provider Network Solutions of Puerto Rico industry classification
Industry- Product category
- Healthcare Network Management Services
- SIC
- Services-Health Services (8000), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Provider Network Administration & Contracting (PPO Network Management) (HLAEALAE)
- akta.pro secondary industry
- Primary Care Networks, Groups & MSOs (HLAFAGAE)
Keywords
Where Provider Network Solutions of Puerto Rico is headquartered
LocationHeadquarters
- HQ city
- San Juan
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Provider Network Solutions of Puerto Rico business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales
Revenue model
- Network Management Services: PNS generates revenue by managing a network of healthcare providers and contracting with health plans (Medicare Advantage, Medicaid/Plan Vital). They provide credentialing, contracting, billing optimization, and practice management support to healthcare providers while serving as an intermediary between providers and payers.
Go-to-market motion1 record
Distribution channels1 record
Marketing channels3 records
Provider Network Solutions of Puerto Rico product offering
Product offeringCore offering
Provider Network Solutions of Puerto Rico operates as a healthcare Managed Service Organization (MSO) that recruits, contracts, and supports healthcare providers within health plan networks. It delivers provider network management, credentialing, contracting, billing and coding optimization, practice management, and regulatory compliance support as integrated managed services, while serving health plans with claims administration and provider relations. Its offering is delivered bilingually (English/Spanish) to providers and payers across Puerto Rico.
Product overview
Provider Network Solutions of Puerto Rico is a Patient-Centered Managed Service Organization that provides a platform of services connecting healthcare providers with payers. The company offers provider resource centers (Plan de Salud Menonita Resource Center and Medicare Advantage Resource Center) along with credentialing, contracting, and educational support services. The offering functions as a unified managed services platform rather than discrete modular products, designed to help providers grow their medical practice, achieve financial solvency, and ensure quality patient care.
Differentiator
Problem solved
Functional benefit
Products and services
- Plan de Salud Menonita Resource Center A dedicated provider resource portal for Plan de Salud Menonita (PSM) health plan providers, offering forms and guides for credentialing, contracting, demographic updates, and direct deposit (ACH/EFT) enrollment.
- Medicare Advantage Resource Center A dedicated provider resource portal for Medicare Advantage plans, providing education, events, forms, and tools to support providers participating in Medicare Advantage networks.
- Provider Credentialing Services Standalone credentialing support service for healthcare providers, including assistance with the credentialing process required before contracting, access to the official credentialing platform, and support from the credentialing support team.
- Provider Contracting Services Contracting services for individual providers and corporations, including request form submission, ACH/EFT enrollment for direct deposit, and demographic updates with health plans.
- Provider Continuing Education Programs Annual continuing education course calendar for providers covering topics such as hypertension management, cultural competence, kidney condition detection, and mental health integration, aligned with ASES and other regulatory requirements.
Quantifiable outcome
- Provider practice growth and financial solvency
Companies that use Provider Network Solutions of Puerto Rico
Customer profileNamed customers2 records
Segments2 records
Ideal customer profiles2 records
Provider Network Solutions of Puerto Rico technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Provider Network Solutions of Puerto Rico partnerships and signals
Strategic signalPartnerships
Four partnerships are on record, tiered core.
- Plan de Salud Menonita (PSM)corePNS serves as a key partner for Plan de Salud Menonita, a Medicaid managed care organization. They provide provider network contracting services, credentialing support, billing optimization, and administrative services. PNS operates the Plan de Salud Menonita Provider Resource Center, offering forms, guides, and support for providers participating in the health plan.
- MCS (Medicare Advantage)corePNS operates a dedicated Medicare Advantage Resource Center for MCS, providing education, events, forms, and tools to support providers participating in Medicare Advantage plans.
- ASES (Puerto Rico Health Insurance Administration)corePNS supports providers in complying with ASES requirements under Plan Vital (Medicaid program). They provide continuing education aligned with ASES regulatory requirements and support the implementation of APR-DRG payment methodology as mandated by ASES.
- CMS (Centions for Medicare & Medicaid Services)corePNS helps providers navigate Medicare regulations, including 2025 MPFS telemedicine rules, CPT coding requirements, and RADV audit compliance. They support providers in adapting to CMS payment policies and coverage guidelines.
Scale indicators2 records
Recent moves4 records
Expansion highlights3 records
Provider Network Solutions of Puerto Rico competitors and assessment
Company assessmentEmerging players
- Availity: Healthcare information network connecting providers, health plans, and clearinghouses for administrative, clinical, and financial transactions. Comparable as an emerging technology-enabled platform competing with traditional MSO service models like PNS.
- HealthEdge: Provider of modern core administrative processing systems for health plans. Comparable as a technology-focused entrant into payer-provider administration that could disrupt traditional MSO service providers such as PNS.
Broad incumbents
- Conduent Healthcare Provider Solutions: Provider of healthcare administrative and technology services including provider data management, credentialing, and network operations. Directly comparable to PNS in offering provider network and administrative services to payers.
- Cognizant (Healthcare Services): Global IT and business process services firm with a healthcare-focused practice covering provider administration, claims, and payer operations. Comparable as a large-scale competitor offering outsourced administrative services similar to PNS's managed services portfolio.
- Optum (UnitedHealth Group): The largest healthcare administrative services and MSO platform in the U.S., offering credentialing, network management, and billing at scale. Competes with PNS as a potential substitute provider for payer network administration, particularly as payers consolidate.
Direct peers
- Triple-S Management (Blue Cross Blue Shield of Puerto Rico): Puerto Rico's largest health insurer operating across commercial, Medicaid (Plan Vital), and Medicare Advantage lines. It is the most directly comparable counterpart to PNS in terms of market, payer relationships, and administrative scope on the island.
- First Medical Health Plan (Puerto Rico): Island-based Medicaid and Medicare Advantage plan operating in the same provider network and regulatory (ASES) environment as PNS. Highly relevant as a potential counterpart payer client for PNS's network administration and credentialing services.
- MMM Healthcare (Puerto Rico): Medicare Advantage-focused health plan in Puerto Rico serving a large senior population. Comparable to PNS as it operates within the same MA network administration ecosystem that PNS supports through its Medicare Advantage Resource Center.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat5 records
Key risks5 records
Key highlights5 records
Customer concentration
Provider Network Solutions of Puerto Rico social profiles
Digital presenceProvider Network Solutions of Puerto Rico financial estimates
Financial estimateRevenue estimate
Valuation estimate
Provider Network Solutions of Puerto Rico leadership team
Management profileNumber of profiles
Profiles2 records
Provider Network Solutions of Puerto Rico funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Provider Network Solutions of Puerto Rico M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Provider Network Solutions of Puerto Rico
What does Provider Network Solutions of Puerto Rico do?
Provider Network Solutions of Puerto Rico operates as a healthcare Managed Service Organization (MSO) that recruits, contracts, and supports healthcare providers within health plan networks. It delivers provider network management, credentialing, contracting, billing and coding optimization, practice management, and regulatory compliance support as integrated managed services, while serving health plans with claims administration and provider relations. Its offering is delivered bilingually (English/Spanish) to providers and payers across Puerto Rico.
Is Provider Network Solutions of Puerto Rico a public or private company?
Provider Network Solutions of Puerto Rico is a private company. It is classified as unknown and is currently operating.
When was Provider Network Solutions of Puerto Rico founded?
Provider Network Solutions of Puerto Rico was founded in -1. It employs 101 to 250 people.
Where is Provider Network Solutions of Puerto Rico based?
Provider Network Solutions of Puerto Rico is headquartered in San Juan, United States, in the North America region.
How does Provider Network Solutions of Puerto Rico make money?
One revenue line is on record: network Management Services.
Who are Provider Network Solutions of Puerto Rico's main competitors?
Emerging players on record are Availity and HealthEdge. Broad incumbents are Conduent Healthcare Provider Solutions, Cognizant (Healthcare Services) and Optum (UnitedHealth Group). Direct peers are Triple-S Management (Blue Cross Blue Shield of Puerto Rico), First Medical Health Plan (Puerto Rico) and MMM Healthcare (Puerto Rico).
Does Provider Network Solutions of Puerto Rico have an API?
No public API is recorded for Provider Network Solutions of Puerto Rico.
What industry is Provider Network Solutions of Puerto Rico in?
Provider Network Solutions of Puerto Rico's product category is Healthcare Network Management Services. Its primary akta.pro industry code is HLAEALAE, Provider Network Administration & Contracting (PPO Network Management), with a secondary code of HLAFAGAE, Primary Care Networks, Groups & MSOs. Its SIC code is 8000.