San Juan Independent Practice Association
Our Vision:

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

Recent News: UPDATED 08/07/2018
  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.


All Presbyterian Contracted providers: Claim Denial (see impacted codes attached)

“CMS just released a new set of MUE’s (max frequency) to be set as zero.  These services are services that PHP would pay for and are incorrectly denying for MUE’s.  I have attached the codes that are impacted.  PHP has submitted an urgent request to Change Healthcare to have the MUE’s for these codes go back to what they were prior to 7/1/18.  We know this will impact many providers and members.  Please let the providers and members know we are working very quickly to resolve this issue. 

Once the fix is in production we will run a report to have the impacted claims adjusted.”

Lilly Aaron | Relationship Executive

Provider Network Management


All San Juan IPA Members and Staff:  3rd Quarter Round Table Meeting

PLEASE RSVP, San Juan IPA will be hosting our third quarterly “Round Table” meeting.  The meeting are for all Members, Office Managers/Administrators and Billers, and any staff you believe may benefit. The next meeting is scheduled for Wednesday August 22, 2018 at 12:00pm-1:00pm at the Courtyard Marriott (La Plata/San Juan). Please note lunch will be provided and we want to be sure to have plenty of food. You may contact Kami Calder ( or Heather DeLaBarcena ( to RSVP.  Remember, this meeting is for you and your participation is important!

This meeting’s agenda will focus on:

Introduction to Risk Management for Medical Practice

IT Security/Email Security

All Alamogordo, Albuquerque, Santa Fe, Las Cruces, Las Vegas and Gallup members are welcome to join remotely.  You may access the meeting online. For access information please email Kami Calder ( or Heather DeLaBarcena (

Did you know? The IPA can provide your practice 4 free hours of IT services a year?  After that it is a low hourly cost to you.  We also host your email services!  We can transfer your current email, assist with the transition all throughout the process, and you won’t lose your existing email!   We offer full collaboration within your organization such as group calendaring, secure web-client, inner office instant messaging for your employees, smart attaching documents for sensitive emails, and mobile sync! Email is an important subject in todays practice. We see a lot of providers using Gmail and Yahoo to sending sensitive documents.  Let us help you move away from those and use a system that has more to offer then just email.   We also can remote manage and monitor your IT systems for you.  Let us help you make sure that all your systems are working and maintained.  Give Matt Bowman, IT a call at 505-564-7910 for details!


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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.