North Coast Physicians IPA is an OPEN network of providers. If you meet the following criteria you are eligible to participate with our IPA and will be able to take advantage of the many benefits of our organization.

• Resident of California
• Licensed to practice medicine in the state of California
• Active DEA certificate
• Admitting privileges at participating hospital or hospitals
• Board certified or board eligible in practice specialty
• Malpractice insurance coverage limits of $1million/$3million

All interested physicians must submit a completed application with the requested attachments. A completed application with all current attachments can complete the credentialing process in 30 - 45 days. Once credentialing is completed, the Membership Committee reviews the completed application and then submits it to the Board of Directors for final approval. Upon final approval, the new physician application is mailed to all of our contracted health plans. Because we are responsible for credentialing on most of our health plans, your application will be entered into the health plans data base within 30 days.; non-delegated health plans take from 30 to 120 days to complete the credentialing process. Your office manager will be informed of which plans we are responsible for credentialing so that the progress or your application can be monitored.

Contracts
All of the IPA contracts are fee-for-service. You submit your claims directly to the health plan or payor and they pay you directly fee-for-service, based on our negotiated contract rates. The IPA does NOT take a portion of your reimursement.

     Complete List of IPA Contracted Insurance Plans

You will receive a copy of our reimbursement matrix. This matrix outlines the agreed reimbursement amounts based on catetory of service, (e.g., Medicine, Surgery, Radiology). The negotiated rates of reimbursement are the highest available in Southern California.

Membership Dues
Each member of the IPA is responsible for payment of dues. There is no income tool for the IPA, so this is how expenses are paid. The North Coast Physicians IPA membership dues are lower than those for any other non-risk IPA. In fact, our members were given a 40% discount on their dues in 1995; this discount has continued through the present. Because the IPA maintains a low overhead, the adjusted savings are passed on to the members. If your practice qualifies as a group you are eligible for a discounted group rate.

Benefits of Membership
The primary benefit of belonging to the IPA is that you are connected to twenty-three health plan contracts by completing just one application. The IPA does all of the work for you when these health plans are re-credentialing. We ensure that you receiveing the best reimbursement for each contract. The IPA administrator will act as liason if a problem arises between your office and the contracted health plan.

Your office manager will be invited to at least four educational seminars annually, at no cost to you. These seminars range from health plan updates and presentations to instruction on how to put together an equitable benefit package for your employees. This IPA consists of many "small businesses," so when a seminar focuses on business matters, it is geared to the small business.

If your questions have not been answered by the above information provided, please do not hesistate to contact the IPA Administrator.

Last Updated Thursday April 24, 2003