In the June 2013 edition of
Partners in Health UpdateSM, we introduced an incentive opportunity to primary care providers who have face-to-face encounters and submit SOAP (Subjective, Objective, Assessment, and Plan) Progress Notes for their Medicare Advantage HMO or PPO members who, based on our claims data, may not have had an office visit with their primary care physician (PCP) in the past year or who may have a chronic condition.
Program changes for 2014
IBC has made the following changes to this incentive opportunity:Eligible membership expansion. Previously the submission of a SOAP Progress Note was limited to Medicare Advantage HMO and PPO members. This year, providers can submit a SOAP Progress Note for certain
commercial HMO, POS, and PPO members.Incentive payment limitation. Last year, every SOAP Progress Note submitted by providers for their Medicare Advantage HMO or PPO members was considered eligible for an incentive payment. The incentive payment is now limited to
six electronic SOAP Progress Note submissions per practice for each eligible member, per calendar year.The results from your physical exam and assessment can be entered into the electronic SOAP Progress Note directly through the ePASS
® system at
https://epass.inovalon.com. To begin a member assessment, select the patient tab by searching for the individual member.After submitting your SOAP Progress Note via ePASS
®, be sure to report the same diagnosis codes on the member's claim. Aligning this information will 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.