INTEGRATED HEALTH PLAN (IHP) FREQUENTLY ASKED QUESTIONS

1. “What is IHP and what can IHP offer to my practice/facility?” IHP spends millions of dollars marketing the network, on behalf of its contracted providers, to health payors. IHP acts as the intermediary, bringing the provider and payor together. Payors often don’t want to spend the time or financial resources necessary to build a national credentialed provider network or do not see a benefit in contracting with certain individual providers. By contracting with IHP, the payor has access to a national provider network through one contract whereby all of IHP’s providers are accepted into such client payor programs. Likewise, providers, through one contract with IHP, gain access to more than 20,000 clients/payors/employers that represent more than 15 million covered lives nationwide, which benefits providers as they are typically unable to affiliate on their own with large national managed care companies such as our clients. In the event such affiliations are allowed, they typically involve a fee schedule arrangement less beneficial to the provider than the percentage of billed charges mandated by IHP’s contracts with its clients.

2. “Where do I send claims and how quickly are claims paid?” Being that IHP is not a payor, claims are to be sent to the payor’s address listed on the members ID Card and the payor will send payment directly to the provider. Claims are typically paid within thirty (30) days of the payors’ receipt of a clean claim.

3. “How will I know if a patient is an IHP member and what services are covered?” IHP sends a listing of the different logos that may appear on member ID cards along with other descriptive information about IHP in the “Welcome” materials sent to providers within 30 days of IHP’s approval of the provider’s application, credentials, and contract. To avoid any confusion, as with all other patients, in determining contract rates and benefits, you should always refer to the patient’s health insurance card and call the number(s) indicated to verify eligibility and benefits. Upon acceptance into the IHP Network, IHP will send “Welcome” materials to your office indicating the different logos that may appear on an IHP member’s ID card to further assist you in identifying IHP members.

4. “How many covered lives are in my area and how many patients can I expect to get from joining IHP?” More than 15 Million members have access to the IHP Network nationwide. Please call our Provider Relations Department Toll Free at (888) 640-8707 enter ext. 307 to determine the approximate covered lives in your service area. Most IHP client payors offer plans whereby the member can choose their own provider, so it’s difficult to give actual projections. However, we can tell you that we very rarely (if ever) contract with more than 5% of any given specialty in any given area in an effort to make the network attractive to enrollees, yet streamlined to ensure appropriate provider volume.

5. “Can you tell me some of the insurance companies and/or employer groups in my area?” Click here to review the Partial Listing of Payors. At the top of the Partial Listing of Payors, click the highlighted area that says “click here”. Please contact our Provider Relations Department at (888) 640-8707 Ext. 307 to obtain our Website password to review our long list of Client/Payors. Click on ‘download’ for the list. Choose your state and print. Please remember that the scope of IHP’s business is to build and maintain the provider network and to market the network to clients/payors. Approximately 20,000 different clients/payors have access to the IHP Network representing thousands of different employer groups. Furthermore, some of IHP’s clients represent multiple payors, e.g., third party administrators (TPAs). Consequently, obtaining and maintaining ever changing employer listings (or payor listings in the case of TPAs, etc.) is a monumental task.

6. “If I already have a contract with one or more of the clients/payors on IHP’s Client/Payor Listing - how will this affect my relationship with such client/payor?” Some IHP clients/payors use IHP on a national basis and some utilize IHP on a regional basis. Furthermore, some clients/payors may utilize IHP for certain products/benefit programs and not others. If you already have a contractual relationship with an IHP client/payor, that contract shall continue to govern the relationship between your practice and that client/payor. If a provider already has a contract in place with an IHP client/payor, this typically means that such client/payor is not utilizing IHP in your service area. Once again, to avoid any confusion in determining contract rates and benefits, you should always refer to the patient’s health insurance card and call the number(s) indicated to verify eligibility and benefits.

Note: Be sure to send in your contract at your earliest opportunity to ensure inclusion in provider directories which offer your practice exposure to clients/payors and members.

Please call our Provider Relations Department Toll Free at (888) 640-8707 Ext. 307 or email us at ProviderRelations@ihplan.com if you have further questions or need assistance in any way. We look forward to your participation in the Integrated Health Plan Network and will work hard to make the Integrated Health Plan contract an asset for your practice.