Narrow network IPA


Howie’s note: when you first open doors everyone is paranoid that their practice won’t succeed because of being excluded from narrow network plans. There have plans I have been trying to get onto for years that have exclusive contracts with the big groups in town as described above. Guess what, my practice is doing fine and I’m as busy as I want to be.

Ironically, some of my referring primary care docs told me they tried to lobby to get me on one of these plans because they like my practice more than the big groups in town. The bottom line is you don’t have to be on every single plan, nor should you feel obligated to be on a plan if they pay poorly or don’t pay at all, or set up a ton of roadblocks like prior authorization.

One thought on “Narrow network IPA

  1. “Recently, I found out that there are actually two different types of IPAs. One acts as a broker, helping physicians to negotiate direct contracts with various insurance companies. By representing multiple physicians, it has more bargaining power to obtain competitive rates. This form of IPA plays no role in managing patient insurance benefits and processing claims. I joined this type of IPA last month”

    Are you sure about this? I ask because this would be an illegal activity colloquially know as “price fixing”. The FTC would be interested in this arrangement, I assure you. Your IPA is probably a “messenger model”, which does not do any collective bargaining.

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