Our Vision:


© Copyright San Juan Independent Practice Association, 2018. All Rights Reserved.


Recent News: UPDATED 05/01/2018
  1. To ensure that a heath care delivery system is in place, which provides available, accessible and adequate numbers of facilities, locations, and personnel for the provision of health care services.
  2. To ensure that a health plan members are provided covered services without regard to race, color, creed, sex, religion, age, national origin, ancestry, marital status, sexual preference or physical or mental handicap.
  3. To ensure that the SJIPA has in place the organizational and administrative systems capable of messaging medical services contracts between providers and third party vendors
  4. To ensure that the quality of care to all patients continues at the highest level of  care possible.  
  5. Provide support for community health education and wellness.


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The information contained within this message is for your use, in order to inform you of any changes that may be occurring at the San Juan IPA, or within the medical community. Please read each message carefully, as they contain important information that may directly affect your practice.


ALERT

San Juan IPA Contracted Members: Contract Updates

Centene/Western Sky: This payer is relatively new to New Mexico and is one of the three MCOs that will be handling the Centennial Care line of business (BCBSNM and Presbyterian are the other two).  We understand that Western Sky sales representatives have been calling our members asking to contract.  San Juan IPA and Centene are working on a contract for Centennial Care and the DSNP program, and we have requested that they stop calling our members until we have gone through that process.


Molina lab:  Members in the San Juan County members may have been receiving denials for labs done in-office.  Molina posted a bulletin in January notifying members that all labs must go through an “independent laboratory”.  San Juan IPA did not receive this bulletin, and to our knowledge our members didn’t receive it directly either.  Upon request it was determined that Molina wants all labs sent through Quest Diagnostics.  However, there is no Quest laboratory in San Juan County, so we have notified the payer that this is not an option.  Molina is to respond to our concerns by the end of business today (4/30/18).



Casey Crotty

Chief Executive Officer

San Juan IPA and Affiliates



Did you know? Not collecting copays and deductibles can result in a fine? See example from UHC 2018 Provider Administrative Guide

                             



Contents of this email:

SJIPA Contract Updates


Member Login:

The San Juan IPA was founded in 1986 by a group of 21 community physicians to partner with

insurance companies with the goal of improving the quality of care to patients while simultaneously

decreasing the cost of care to those payers. Originally formed with a “Quality Assurance Committee”,

the San Juan IPA has grown to over 450 members representing 39 specialties and sub-specialties

in 70+ offices across New Mexico, a HEDIS quality review function, a Credentialing Committee,

and a care management committee component.


As an NCQA-accredited organization, San Juan IPA’s core services of contracting and

credentialing are complemented by an array of expanding resources for the physician office,

helping keep practice costs low and quality of care high.  We continually look for ways to

promote new quality initiatives both within and outside the practice walls for patients and employers.