The following services can be provided on a consultative (one-time) or ongoing basis.
IPA Solutions identifies areas of financial, operational, and legal concern to discuss with you and/or your legal counsel to help you negotiate a win-win agreement with the health plan, IPA, or Medical Group. These services typically minimize your legal fees and operational costs while maximizing your reimbursement.
IPA Solutions can assist you evaluate if the rate being currently being paid or being offered to you is fair for the services you are providing. While this sounds simple, many capitated agreements can be very difficult to analyze and administer because of the complexity of different responsible payer organizations, different payment methodologies and/or rate differentials by place of service or service category. We have the ability to model any contract, no matter how complex.
IPA Solutions knows how to create and apply claims adjudication guidelines, using national and proprietary formats, to help prevent system gaming and support a fair compensation distribution methodology that maintains contract profitability for your organization.
IPA Solutions can also help your group implement a distribution methodology that works in concert with your claims adjudication guidelines to align provider incentives towards your organization’s quality and utilization management goals.
IPA Solutions can facilitate the completion of a formal quality assurance and utilization management plan, including how to monitor and demonstrate plan effectiveness through the capture and reporting of quality indicators.
IPA Solutions can assist in the creation of clearly defined bookkeeping and accounting tasks, including provider claims payments, accounts payable, payroll, and coordination with your accountant for tax preparation services.
