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Referral Survey

Humboldt County Referral Survey Results Survey Results During the months of October/November 2014 the IPA surveyed primary care providers (PCPs), specialists, office managers and referral coordinators regarding the referral process in Humboldt County. The survey consisted of 12 questions covering four areas: transitions of care, access, collaborative care management and patient communication. 52 people responded … Continue reading “Referral Survey”

REFERRAL IMPROVEMENT PROJECT

As a result of the high energy, emotionally charged and well-attended (65 persons representing 27 medical practices and organizations) November 20, 2014 Primary Care Renewal Collaborative meeting the IPA has decided to help facilitate the effort to address referral issues that surfaced during that meeting.  Beginning in January 2015, in addition to providing this resource … Continue reading “REFERRAL IMPROVEMENT PROJECT”

REFERRALS

A survey conducted in late 2014 of Humboldt County’s primary and specialty care providers, office staff and patients suggested a strong desire to see improvements made in the way referrals were handled. Complaints ranged from lost referrals, irrelevant, unclear and insufficient information included in referrals, great delays in scheduling and receiving specialty appointments. As a … Continue reading “REFERRALS”

CARE MANAGEMENT PROGRAMS

All Humboldt IPA health plan members are eligible for enrollment into Care Management as part of their benefit plan. The Humboldt IPA’s care management services help members navigate the health system and develop life skills for healthy living.The role of the care manager is to assist members with complex or multiple conditions obtain access to … Continue reading “CARE MANAGEMENT PROGRAMS”

AUTHORIZATIONS

  Submit an Authorization Request  Utilization Management decision making is based only on appropriateness of care and service and existence of coverage.  The Humboldt IPA does not specifically reward practitioners or other individuals for issuing denials of coverage or services.  The Humboldt IPA does not offer financial incentives to UM decision makers that encourage decisions … Continue reading “AUTHORIZATIONS”

CLAIMS

We have switched to a new system. Instructions for using the new provider portal can be found here. Submit Claims or Check Claims Status For more detailed information about submitting claims, settlement practices, and dispute resolutions click here. Electronic Claims Submission The Humboldt IPA accepts claims through the following clearinghouse: Office Ally http://www.officeally.com Claims MUST … Continue reading “CLAIMS”

MEMBERSHIP AND CREDENTIALING

The Humboldt IPA is a delegated physician group including non-physician providers for HMO health plans as well as a third-party administrator for local employer PPO health plans. By credentialing with the Humboldt IPA network, you will become a participating provider for members of the following health plans: Anthem Blue Cross HMO Blue Shield HMO (except … Continue reading “MEMBERSHIP AND CREDENTIALING”