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

Texas

The National Provider Alliance (NPA) 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.  The objective of this collaborative effort is to offer surgical assistants a chance to be paid for independent surgical assisting services in an insurance-entity recognized network.  

On a monthly basis, ASA will send a list of current Surgical Assistants to NPA to confirm eligibility for the network. 

NPA executives have worked closely with the managed care industry over the past few decades and have extensive knowledge of what it takes to build solid networks. This knowledge also enables us to negotiate more competitive reimbursement rates that would otherwise not be possible if done on an individual basis.

Our services to you will include negotiating contracts with the managed care plans, billing the managed care plans on your behalf, and the collection and disbursement of timely payments to you.  Although we provide a billing service, you will retain the option of continuing to use your current billing company.  Details of how the new process will work are provided in the billing section of this welcome packet.

Our ability to organize, negotiate, bill and collect as a single entity makes us extremely attractive for managed care plans to contract with NPA.  This type of model and approach will result in significant administrative savings for the managed care plans because they would be working with one large entity as opposed to contracting individually with numerous surgical assistants.  This model has proven to be very successful for primary care physicians, specialists, and ancillary services.

To date, we have worked with the surgical assistants in Florida and currently have a contract with Cigna and it is our goal to do the same in other states!  The terms of the contract are listed in the Individual Provider Agreement.  We strongly recommend that the financial terms of the contract be kept confidential.  Should the minimum compensation (as outlined in the Provider Agreement) not be met, the Provider Agreement will then become null and void.  It is our intention to obtain the highest reimbursement rate on behalf of the surgical assistants but in order to do that we need to show that we have a large network of surgical assistants that want to participate.

 To participate in this network, we have enclosed the following documents:

 

  1. Provider Agreement between NPA and the individual surgical assistant.
  2. Billing Package which contains information necessary to receive and process Cigna claims and a description on how the process will work (you will also need to enter your National Provider Identifier –NPI- in this section.  If you do not have one, please go to: https://nppes.cms.hhs.gov/NPPES/Welcome.do and apply online.  It takes about 10 minutes to apply and then you will be emailed your number shortly after submitting the information).
  1. W-9

 

In order to be a part of the NPA network, we would ask you to execute the attached documents (Individual Provider Agreement, Billing Info and W-9), and return it as soon as possible.  You can email, fax or mail these documents to:

 

melaney@nationalprovideralliance.com

 

713 East Park Avenue

Tallahassee, Florida 32301

 

(850) 224-7968 (fax)

 

Upon receipt of the executed documents, NPA will then be able to show the health plan what the network of surgical assistants will look like within the state and then be able to agree to a strong reimbursement rate for the network.  Once the reimbursement rate has been agreed to, we will let you know.  Should the minimum reimbursement rate (as outlined in the Provider Agreement) not be met, the Agreement will become null and void and you will automatically be released of any and all contractual obligations.

We understand that this may be a lot of information to take in and are available to answer any questions that you might have during this process.  Please take a look at the FAQ page to see if that might help answer any questions that you might have.

We are thankful for the opportunity to work with you and look forward to many more plan negotiations on behalf of surgical assistants.

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

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