ATTORNEY FAQS

What is an Independent Physician (Provider) Association or IPA?
Our IPA represents an association of independent practitioners and providers (State compliant legal entity) who have come together to be more “connected” and to have, by their number and the number of patients (Lives) they service, leverage in the marketplace. The formation of an IPA and its association with it is the inverse of PE-backed Hospitals, ASC management companies, and Healthcare Insurers’ “trojan horse” entities, all seeking to control the pricing in the marketplace and eliminate free-standing competitive facilities and independent physician practices. For decades, IPAs in the United States have been the Gold Standard and customary mechanism for healthcare delivery of insurance payor products for HMO, PPO, POS, EPO, Medicare, and Medicaid (AHCCCS) payers. The number of IPAs, the volume of lives held in each, and the product offerings vary from State to State but, without exception, are ever increasing as a percentage of the market share in each State. They are more inclined through the multi-specialty model (Azure has 47) and like coverages throughout the State to provide tailored care to the patients in need with the best medical practices to provide quality and connected care.
Why is this a better model for the care of my clients (patients)?
High Level:
  • 47 Specialties and Sub-Specialties including Neuropsychology, TBI specialists, Spine, Neurology, Psychology, Physiatry, Cardiology, Neurosurgery, Orthopedics, Pain Management, Occupational Health, Neuro-Ophthalmology, etc.
  • Sub-Acute, Acute, HOPD, ASC, OTC, Urgent Care, Imaging, and other facility and ancillary care sites.
  • State-wide coverage
  • Sophisticated lien settlements, we understand what you are going through
  • Immediate care
  • Availability of Notes, patient path and calendar, and ability to see what the chargemaster aggregated total is for the patient v the policy limits.
  • Transportation and Translation
  • Case Management
  • One point of contact and electronic access to EHR.

 

The availability of willing providers, especially in subspecialties and facilities, has always been a barrier to appropriate and quality care for personal injury patients. While the State has endeavored to provide Healthcare facilities and providers with the ability to execute liens to provide reimbursement and in the interest of public health, few facilities or specialties commonly participate. Other than in emergency room initial visits, Acute and Subacute facilities see very few lien patients other than when the patient’s own health insurance incorrectly assumes the liability of the third-party payor. While Arizona is an anti-subrogation state, confusion abounds in understanding the implications, legal rights, and differences in payor types such as Medicare, AHCCCS, shared plans, employer private-public arrangements, Balance billing, timely filings, and the new state bill ARS §33-931 – §33-937. Providers willing to make the foray into this new payor often are left holding the proverbial bag on a contrived snipe hunt. Azure, managed by Transformative Medical, which has extensive experience in the personal injury field across the nation, is a sophisticated operations team to assist providers in embracing this new payor. Being able to offer to legal offices medically led, appropriate care, all specialty and facility partner in building your client’s case with fantastic outcomes, competent notes, and the finest providers in Arizona who, unto themselves, represent expert witnesses for each instance of care. An in-network model with no stray providers offers security and unprecedented timeliness to demands, settlements, and resolution of your cases. No overtreatment, inappropriate care pathways, best-in-class providers, reasonable chargemaster, and sophisticated case resolution of liens with a healthcare partner make building your case a one-stop shop with great outcomes and word-of-mouth referrals.  

How do I refer to the IPA?

Just sign the electronic signature document we sent, and we will send you back a calendaring application so we can meet in person!

Bottom line - What is the result of us using the IPA?
We believe the following is the answer to that question:

  • Connected care, Doctor managed, in a legal healthcare entity with the best-in-class providers removes implications of layperson referral
  • Case Managed, all in-network, easy to obtain all patient records, notes and images through our electronic portal and to see patient calendar
  • ”Building” your case through complete network of providers and facilities, expert quality with competent notes and path of care
  • Excellent outcomes and patient satisfaction means more referrals
  • Sophisticated and Lawyer friendly resolving of patient bills and only one single lien for the IPA to compromise on.