Benefits of Joining an IPA

An Independent Practice Association (IPA) is comprised of individual healthcare providers that can unite to make changes in the healthcare world. IPAs can pull resources, gather opinions and information, and work towards a common goal. By becoming a member of PIPAC, a provider would then become a member of the largest private IPA in West Virginia!

Timeline for Enrollment

To become a PIPAC member and receive the benefits we offer, each provider must complete and return to us the West Virginia State Mandated Application. This application is then sent to our Credentialing Verification Office (CVO) where a background check is completed for each provider. Once the background check is cleared, each provider is given a date that corresponds to the date of the CVO completion. This date is the effective date that is given to each of the delegated companies and each company will backdate claims to this date. The background check on average takes around 14 days to complete.

Once the CVO report is completed and sent back to PIPAC, we begin the process of credentialing by enrolling providers in the insurance companies. PIPAC completes each application for enrollment and sends them to the proper representative for enrollment. The timeline for enrollment in each company varies depending on the speed of their internal process. Some companies, such as PEIA, can have the enrollment completed in less than 24 hours. Other companies, such as Tricare, can take up to 180 days for them to process and enroll each provider. Most of the companies will have enrollment completed within 60 days and allow providers to begin billing for reimbursement. PIPAC will continuously receive confirmations of provider enrollment and pass along the information to the provider.

Each of the insurance companies we work with has a provider representative that we directly correspond with to get status updates and receive confirmation of enrollments. This is a major benefit for providers because it allows PIPAC to view enrollment status in real-time, allows faster correspondence, and relay of incorrect or missing information on a provider’s application. If an issue arises in enrollment due to incorrect information, past issues, lawsuits, or missing information, PIPAC can quickly react and correspond with our provider representatives to correct the information and ensure that enrollment continues unburdened.

Affiliations

PIPAC offers services through connecting groups exclusive to members that are essential for healthcare practices. WV Caring (hospice care) provides aid and instructional help for elderly care, Atlantic Health Partners is the largest vaccine distributor to healthcare providers in the USA and offers group discounts, and malpractice insurance offered through AMS RRG, an A-Rated, physician-owned, Risk Retention Group.