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January 2020 Provider eConnection
news for IPN Provider Offices
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Website Changes | PCP or SCP - That is the Question! | Run-Out Repricing | PacificSource Update| Cigna Update| Cypress Update | IPN in the Community |Staff Spotlight
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Website Changes
IPN has been working to improve its website to a more user friendly format. Although
small changes may be noticed as early as December, the most impactful changes will not go live until January 2020. Changes to the website include:
- Contact Us: now includes email addresses
- Credentialing: expanded to include Frequently Asked Questions
- Join IPN: easy to understand instructions for new or potential providers
- Provider Tools: includes new tools such as a Credentialing Matrix and a reference sheet to know which forms are required for the credentialing of each provider type
- Forms: new and existing forms in one central location, including the Practitioner and Organizational Provider Application, Provider Information form, Prescribe Plan and Hospital Admit Plan
We appreciate your patience as some sections of the site may be unavailable for a short time but we are always happy to answer questions you may have. Once all changes are live, we would value your feedback!
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PCP or SCP - That is the Question!
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Physician and mid-level providers will indicate on the initial credentialing or recredentialing application whether IPN should report them to its payors as Primary Care Providers (PCP) or Specialists (SCP). To qualify as a PCP, education, training and board certification must be verified. Such verification becomes part of the individual's IPN credentialing record and simply indicates whether the provider is
qualified to act as a PCP. The PCP qualifying specialties and subspecialties* based on education, training and/or board certification include:
- Family Medicine
- Internal Medicine
- Pediatrics
- OB/GYN
- GYN
If a provider elects to act as a PCP for
all payors, IPN will ensure the credentialing record is current and notify payors to consider a PCP status. If a provider wishes to act as a PCP for
specific payors but not
all payors, arrangements must be made directly with the payor.
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Run-Out Repricing
IPN provides run-out repricing for some terminated groups. To see a list of those groups click the button below. Included in the list are:
- Employer Group Name
- Employer Group Number
- Claim Submission Information
For more information related to these employer groups, contact the payor at the number listed on the member identification card.
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PacificSource Update
Currently the effective date of providers for PacificSource is the first day of the month following the provider's approval date by IPN's credentialing committee. That is about to change.
Effective January, 1, 2020 providers may be effective the date the credentialing is approved.
PacificSource Commercial: The effective date will be the IPN approval date OR the agreement effective date, whichever is later.
PacificSource Medicare: The effective date will be the IPN approval date OR the agreement effective date OR the Medicare eligibility date, whichever is later.
Please contact your PacificSource Provider Service Representative for additional clarification and questions.
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Cigna Update
Utah-Idaho (UT ID) Teamsters
UT ID Teamsters Security Fund and UT ID Retirees Trust Account will be adding Cigna under a Shared Administration Repricing (SAR) contract for the Open Access Plus (OAP) Network, effective January 1, 2020.
What this means to providers: While members will continue to access the IPN-contracted network of providers, the claim filing address and precertification requirements will change, effective January 1, 2020. Therefore, we encourage providers to pay careful attention to the new ID card for these members (sample ID card
attached), and note the appropriate claims address and precertification phone numbers for dates of service on or after January 1, 2020.
For dates of service prior to January 1, 2020, please continue to submit claims to the address noted on the 2019 member ID card for the Account.
Communication Update
- During the 1st quarter of 2020, Cigna will be making several changes to the administrative, reimbursement, and medical coverage policies related to Allergy Testing & Non-Pharmacologic Treatment, Anesthesia Services for Interventional Pain Medicine Procedures (Adults), Care Integration Services, Evaluation and Management Services & Joint Injections and Incontinence Supplies.
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A flyer about electronic prior authorization for pharmacy services is now available, and is attached. The flyer outlines the advantages of electronic prior authorization and provides the options for submitting electronic prior authorization requests.
These changes and more can be found in the Network News: January 2019 issue at
CignaforHCP.com
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Cypress Update
Cypress Benefit Administrators, the TPA for McGuire Bearing Company, will be officially rebranding as Lucent Health effective January 1, 2020. According to the announcement, "While the logo is different, the product is the same."
This is a great reminder that many payors will be issuing new ID cards for the 2020 plan year. Remember to collect those from patients so billing staff has the most up-to-date information.
Click
here for the full announcement.
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IPN in the Community
In Idaho, more than 200,000 people are food insecure. Thankfully,
The Idaho Foodbank has been serving our community for the last 35 years, working with more than 230 community-based partners to provide food to those in need through programs like
Cooking Matters,
Mobile Pantry and
Stamp Out Idaho.
Some of IPN and PacificSource's Provider Network team members volunteered at The Idaho Foodbank distribution center in Boise. Time was spent sorting and packaging fresh apples that were later delivered to local partners in Southeast Idaho. To support this non-profit or l
earn more about The Idaho Foodbank, visit
idahofoodbank.org
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Staff Spotlight
When she is not in the office brightening our day, Gina Stewart is donating her time and money to local non-profits. Just during this holiday season,
Gina supported S
t. Vincent de Paul Toy Store, United Way, Festival of Trees and The Idaho Foodbank. Kudos to Gina and all the work she does to support our community!
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IPN Team Member Directory
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Customer Service
Allyssa Wood
Kyler Jackson
Leona Campbell
Payor Relations
Megan Smith
Provider Relations
Amy Campbell
Michelle Ridlon
Credentialing Specialists
Frankie Campbell
Jennifer Ford
Samantha Adams
Stefani Borja
Credentialing Coordinator
Meagan Meter
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