As previously communicated, eligible Pennsylvania primary care physicians must be NaviNet-enabled at each practice site and use the NaviNet® web portal as the primary mechanism for claims status inquiries, adjustment requests, referrals, and initiation of applicable preauthorizations to participate in the Quality Incentive Payment System (QIPS) program.
Practices must also register for electronic funds transfer (EFT) for non-capitated reimbursement and complete the following transactions electronically:
These prerequisites must be met to be eligible for QIPS payments beginning July 2011.
Please review the QIPS Program Manual, which is available on NaviNet, for additional information about these new requirements for measurement year 2010. If you do not have access to NaviNet, you can submit an online request at www.ibx.com/providersupplyline or call the Provider Supply Line at 1-800-858-4728 to request a printed copy.
For additional information regarding QIPS, please contact your Network Coordinator.