September 24, 2013
The National Provider Alliance (NPA) was approached by the Association of Surgical Assistants to come up with a way for independent surgical assistants to be able to contract with major independent insurance companies. The objective of this collaborative effort is to offer Florida surgical assistants a chance to be paid for independent surgical assisting services in an insurance-entity recognized network.
On a monthly basis, ASA will send a list of current Surgical Assistants to NPA to confirm eligibility for the network.
NPA executives have worked closely with the managed care industry over the past few decades and have extensive knowledge of what it takes to build solid networks. This knowledge also enables us to negotiate more competitive reimbursement rates that would otherwise not be possible if done on an individual basis.
Our services to you will include negotiating contracts with the managed care plans, billing the managed care plans on your behalf, and the collection and disbursement of timely payments to you. Although we provide a billing service, you will retain the option of continuing to use your current billing company. Details of how the new process will work are provided in the billing section of this welcome packet.
Our ability to organize, negotiate, bill and collect as a single entity makes us extremely attractive for managed care plans to contract with NPA. This type of model and approach will result in significant administrative savings for the managed care plans because they would be working with one large entity as opposed to contracting individually with numerous Surgical Assistants. This model has proven to be very successful for primary care physicians, specialists, and ancillary services.
At this point, we are excited to announce our first major contract with Cigna Healthcare! Cigna has agreed to contract with all surgical assistants in the NPA network. The terms of the contract are listed in the Individual Provider Agreement. We strongly recommend that the financial terms of the contract be kept confidential.
To fully execute this contract, we have enclosed the following documents:
1. Provider Agreement between NPA and the individual surgical assistant.
2. Billing Package which contains information necessary to receive and process Cigna claims and a description on how the process will work (you will also need to enter your National Provider Identifier –NPI- in this section. If you do not have one, please go to: https://nppes.cms.hhs.gov/NPPES/Welcome.do and apply online. It takes about 10 minutes to apply and then you will be emailed your number within 10 minutes of submitting the information) and a W-9.
3. FAQ sheet that will hopefully address any additional questions that you might have.
If you choose to accept the terms of the deal negotiated by NPA, we would ask you to execute the attached documents (Individual Provider Agreement, Billing Info and W-9), and return it as soon as possible. You can email, fax or mail these documents to:
713 East Park Avenue
Tallahassee, Florida 32301
(850) 224-7968 (fax)
Upon receipt of the executed documents, NPA will provide the health plan with a final roster so they can load the participating surgical assistants into their system. This process will take approximately 30 days from start to finish. The goal is to have all of these documents completed and submitted to NPA by September 27th, 2013. This will allow sufficient time for the plan to “go-live” on November 1, 2013.
As soon as NPA is notified that all of the information has been successfully loaded to the health plans database and we have an effective date, we will communicate with you at which point you can start billing the plan. Typically, a managed care contract will have an effective date of either the 1st or the 15th of the month.
We understand that this may be a lot of information to take in and are available to answer any questions that you might have during this process. We are thankful for the opportunity to work with you and look forward to many more plan negotiations on behalf of surgical assistants.
Kind Regards,
Melaney Cordell
National Provider Alliance, INC.
(866) 576-8705
713 East Park Avenue Tallahassee, Florida 32301
(866) 576-8705