IBC is offering an incentive to
providers who have face-to-face encounters with and submit medical
documentation for Medicare Advantage HMO or PPO members who, based on our
information, may not have had an office visit with their primary care physician
(PCP) in the past year or who may have a chronic condition.
Eligible providers will receive a
letter from IBC describing this incentive opportunity along with a list of
their IBC members who meet the criteria. By submitting a SOAP (Subjective,
Objective, Assessment, and Plan) Progress Note for these members, providers can
earn incentives for the initial submission, as well as any subsequent
face-to-face encounters and SOAP Progress Note submissions. We have partnered
with Inovalon, Inc., an independent company that provides secure, clinical
documentation services, to process member assessments.
The results from your face-to-face
encounters can be entered electronically through the NaviNet? web
portal. By going to the Eligibility and Benefits Inquiry transaction and
selecting the member's Clinical Alert, providers can access the ePASS? system to enter in the appropriate information
from the encounter.
After completing each submission,
please be sure to report the diagnoses codes on claims submissions that reflect
the information submitted in each SOAP Progress Note. It is very important for
this information to be aligned to improve the accuracy of the risk adjustment
used in IBC incentive programs, such as the Quality Incentive Payment System
(QIPS) program for eligible PCPs and the Integrated Provider Performance
Incentive Plan (IPPIP) for eligible organizations.
If you have any questions regarding
SOAP Progress Notes or ePASS, please contact Inovalon at 1-877-448-8125. For questions about this initiative,
please contact Customer Service at 1-800-ASK-BLUE.
Note: Incentive payments will be sent
within 90 days of your submission of the SOAP Progress Note.
NaviNet? is a registered trademark of NaviNet,
Inc., an independent company.