Working to create networks of surgical assistants, one state at a time.

FAQ

Q: I am a doctor group looking to utilize your network.  How do I get a copy of the Provider Directory?

You can email melaney@nationalprovideralliance.com and request one

Q: Why am I receiving all of this information?

The National Provider Alliance was approached by the Association of Surgical Assistants to come up with a way for independent surgical assistants to be able to contract with major independent insurance companies.

Q: What do I need to do?

If you decide that you want to participate in this network, sign the provider agreement, fill out the W-9 and the billing info page and send it all back to NPA.

Q: How much does this service cost me?

The services that are provided by NPA are at no cost to the surgical assistant. All fees are covered in negotiations between NPA and the Plan. Therefore, whatever fee schedule is listed on the provider agreement is exactly the rate at which you will be reimbursed.

Q: What happens next?

Once all of the forms have been received, we will be able to show a plan(s) our existing network and move forward with negotiations.

Q: How do I submit my forms (Individual Provider Agreement, Billing information and W-9)?

You can mail,fax, or email them to us.

National Provider Alliance
713 East Park Avenue
Tallahassee, Fl. 32301

Fax: (850)224-7968

email: melaney@NationalProviderAlliance.com

Q: How long does it take for me to receive payment?

The goal is to have the surgical assistant be paid within thirty days of when NPA receives payment from the HMO. NPA will have a check run once a month and the preliminary schedule will be on the 20th of each month.

Q: Where do I send the claims forms?

They can be mailed, faxed or emailed to:

National Provider Alliance
7100 Pines Boulevard
Suite 23
Pembroke Pines, Florida 33024-7355

Fax:  954-237-2876

email: claims@NationalProviderAlliance.com

Q: What information is needed so that the claim can be successfully processed?

  • Patient full name
  • Patient DOB
  • Relation to insured
  • Marital status
  • Sex
  • Patient address, city, state, zip
  • Patient phone number
  • Insured Plan
  • Insured ID either patient if self or guarantor information if subscriber is different from patient

o      If guarantor is subscriber you will need insured address, phone, DOB, Sex

  • Insurance Group ID
  • Referring physician
  • Diagnosis code (ICD9)
  • Date of service
  • Procedure code (CPT)
  • Rendering provider
  • Service facility location

Q: Can I terminate my Provider Agreement?
Our mission is to bring vlaue to our clients.  If we cannot meet that mission, then you can terminate the contract (at no cost to you).

Q: Do I need an NPI (National Provider Identifier)?

Yes, if you don’t already have one you can get it online in a matter of minutes at: https://nppes.cms.hhs.gov/NPPES/Welcome.do

Q: What if I have my own person who does my billings?

You can still keep them, just ask that they submit the  CMS 1500 claim form to the above-mentioned address, email or fax

Q: What if I don't have a billing company?

We have a billing department and provide that service at no cost to you. You will just need to send in a CMS 1500 (which we can provide to you).  However, if you do have your own billing person/company they can submit the forms directly to us, providing no disruption to you.

Q: Can anyone join this network?

It is only open to members of the Association of Surgical Assistants with a CSFA, SA-C or CSA credential.  If you are not a member of the Association of Surgical Assistants (ASA), you can still submit your paperwork to NPA and then we can assist with your ASA membership.

Q: What is the reimbursement with the health plan contract?

Each contract will have different rates and terms. We will disclose the reimbursement rates to you once the contract(s) have been agreed upon.

Q: Am I directly contracted with the health plan?

No, the surgical assistant will be directly contracted with NPA. NPA is contracted with the plan.

Q: Does NPA plan on contracting with multiple health plans?

Yes

Q: Once I am in-network and am able to bill contracted plans, who do I contact if I have questions about the claims that I have submitted?

You can email questions to claims@nationalprovideralliance.com.

Q: If I am a hospital-based Surgical Assistant, am I allowed to bill for my services?

No, your services are paid by the hospital. Only independent surgical assistants are allowed to bill the insurance company. There may be an opportunity for you to bill for your services if you are moonlighting at a hospital, which you are NOT employed at.

If you have any other questions please email them to: Melaney@nationalprovideralliance.com

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