Provider FAQ

How do I become a JIPA provider?
  1. Submit a request to be contacted by your local JIPA Provider Representative.
  2. Review our contract, and negotiate a rate of reimbursement for seeing JIPA patients
  3. Submit your completed contract and our credentialing application (or submission of an updated CAQH)
  4. During the verification of credentials, providers may utilize the JIPA Network with a Letter of Agreement.
  5. Once your credentials have been verified and approved by a committee of your peers (Credentialing committee), your contract will be given an effective date, signed by an authorized JIPA representative, and returned.
  6. Your JIPA Provider Representative will conduct a full in-service for you and your practice staff, including: Office Manager, front desk staff, Billing & referral coordinators, and any other relevant practice staff.
  7. Providers and their staff will receive a provider quick reference guide, which includes the provider directory.
  8. Provider reps, and Patient Care coordinators will guide you and your office in how to use JIPA to your practices best interest.
How much does it cost to be a JIPA provider?

There is no cost associated with being a JIPA provider. In fact, JIPA is responsible for paying you to take care of authorized JIPA patients.

How do I become a featured JIPA provider? What does it mean to be a featured JIPA provider? What types of providers are eligible members of JIPA?

We contract with any and all types of practitioners and facilities, just as long as they’ve been accepted as member by our credentialing committee. List of prospective providers Include but is not limited to practitioners & facilities, like:

  • Physicians MDs- DOs (all specialties)
  • Podiatrists
  • Optometrists
  • Therapists (Physical, Occupational, Speech pathology, etc.)
  • Hospitals
  • Home health
  • Ambulance Service
  • Medical transport
  • Urgent care
  • Medical imaging
  • Sleep Centers
  • Durable Medical Equipment
  • And more
How do I refer a JIPA Patient?

It’s simple. If you can identify patients that can benefit from JIPA’s services, contact your local Patient Care Coordinator to make a referral and we’ll handle the rest.

How do I receive a JIPA patient?

All JIPA patients must be authorized prior to services being rendered to ensure payment. To confirm authorization, please contact a local Patient Care Coordinator at (954)331-6530.

When do I get my first JIPA Patient?

JIPA’s goal is to increase the volume of patients by becoming a member of JIPA; however, we cannot make that guarantee. JIPA gets its patient base from providers like you that see the benefits of JIPA for their patients and for their practice. (CC points).

How does JIPA choose where a patient is sent?

JIPA does not endorse any one provider or facility, and there is no preferential system for determining where a patient is sent. We do not accept any form of payment or incentives for sending a provider a patient. There are numerous factors that determine where a patient is sent:

  1. The request of the referring provider
  2. Request of the patient
  3. Location of provider in relation to the patient
  4. The patient’s ability to pay for the service charges.
How do I file a claim?

Claims should be sent within sixty (60) days of providing healthcare services to JIPA patients. All claims should be submitted using your Billed Charges and the appropriate procedure code per American Medical Association (AMA) and Center for Medicare and Medicaid Services (CMS) standards. Claims can be submitted via mail or electronically.

How does the Coordination of Care point system work?

JIPA has found a way to compensate providers for the administrative work associated with treating their patients, through our unique Coordination of Care Point System. The system places a weighted value on the amount of effort it takes to coordinate the care of a patient during a referral. These points translate to real incentive dollars for ensuring the best care for our patients. For further details, contact 1(877)749-5472, to speak with a local provider representative for more details.

Does JIPA have a credentialing process? If so, what’s the process?

Yes, we have a four step process:

Step 1: After you have completed and submitted your contract and credentialing application.

Step 2: Our credentialing staff will verify and prepare the applicants’ file for the JIPA Credentialing Committee’s review.

Step 3: the Credentialing Committee convenes to determine if the application is accepted, denied, or requires further Query. Credentialing Committee meetings are conducted to assess the clinical competence of prospective medical providers, allied health professionals, and facilities before being accepted as members of JIPA Network. The Committee consists of a panel of physicians that convene once a quarter.

Step 4: We will notify you of the committee’s decision. If accepted, the provider is then added to the JIPA directory, the contract is signed as effective by an authorized JIPA representative and the original contract is given to the provider with a Welcome Packet and a scheduled in-service by a Provider Representative.

For further information on this process please contact your local provider representative or one of our credentialing administrators.

What are my rights as a provider during the credentialing process?

Information gathered during the verification process, includes information from outside primary sources like state/ national licensure boards and malpractice insurance carriers. We value your privacy and information security. Moreover, by law we are not allowed to release information submitted to either the national Practitioner Data Bank or information that would be considered peer-review protected. But all such factors will be accounted for during the credentialing committee’s review. Please note, JIPA has a contractual agreement with Med Advantage, a credible Credentialing verification Organization, to assist with building the files submitted to the committee.