QIPS Reminder for Electronic Connectivity Requirements and Transaction Prerequisites

To participate in the Quality Incentive Payment System (QIPS) program, eligible Pennsylvania primary care physicians must be NaviNet-enabled at each practice site and utilize the NaviNet^® web portal as the primary mechanism for claims status inquiries, adjustment requests, referrals, and initiation of applicable preauthorizations.

Practices must also register for electronic funds transfer (EFT) for non-capitated reimbursement and complete the following transactions electronically:

• member eligibility
• claims submissions
• encounters

The above prerequisites must be met to be eligible for QIPS payments beginning July 2011.

Read the complete article in the January edition of Partners in Health Update^SM.