SWBHIPA members have the opportunity to choose to participate in the insurance contracts that SWBHIPA offers. SWBHIPA works to standardize the contracts and explain them to our members in a language that is understandable.
SWBHIPA utilizes a streamlined process to help an insurance company establish their network, adding numerous highly qualified mental healthcare providers to their network. Their members, the consumer, then have quicker access to quality mental healthcare.
SWBHIPA helps the practitioner establish their practice and panel with the insurance companies quickly and efficiently. Providers can then offer their services sooner and expand the access consumers have to behavioral healthcare.
SWBHIPA guides the provider helps facilitate communication between the provider and the insurance company to ensure that the provider is able to become a viable provider in the plan’s network as quickly as possible.
SWBHIPA strives to make communication with the insurance companies to be as clear and consistent as possible. An insurance plan can disseminate information quickly to providers, keeping the providers current to the insurance plan’s information and issues that impact a provider’s practice. This includes fee schedule changes, billing procedures, claims resolution processes and plan developments and changes. And when SWBHIPA members have issues, SWBHIPA will work as an intermediary to help resolve them.
SWBHIPA is working to expand benefits by outreaching into new markets and platforms that will provide broader access to behavioral health care for New Mexico’s population. SWBHIPA would like to create opportunities for providers to enhance their business opportunities by collaborating in behavioral health projects. This includes program development, vendor relationships and grants. SWBHIPA’s purpose in all of these endeavors is to build a stronger behavioral health provider population. With the support and work of all our members in the Association, we will be able to strengthen our businesses for improved access to behavioral healthcare in New Mexico.
What if I am not currently on any insurance panels?
SWBHIPA Members have access to SWBHIPA contracts (subject to some limitations due to plan imposed network closures). When you choose to join one or more of the available contracts that SWBHIPA has with the insurance companies, you will get assistance with the application process and joining the plan’s network.
How does contracting work?
As an approved member, you will work with our consultant to review those SWBHIPA contracts which are available to you. Of those plans, you can decide which ones you do or do not want to participate in. Any new contracts will be balloted out to the membership. Your ballot is not accessible to other providers and only seen by IPA staff, who work directly with the insurance companies.
What if I want to contract directly with an insurance company that SWBHIPA is also working with?
SWBHIPA will never discourage providers from working with insurance companies directly. You can choose to contract with a plan directly or you can remain directly contracted with an insurance company if you are already contracted them. You decide which SWBHIPA contracts you wish to join.
Can the IPA contract as a group?
SWBHIPA utilizes the “Messenger Model” for contracting, which is completely confidential, permissible and legal. We highly recommend that all Members educate themselves about antitrust issues. We have in-depth antitrust information under the tab labeled “Antitrust Policy” and we have an antitrust policy that members will acknowledge.
What happens if I decide not to continue or renew my Membership?
SWBHIPA has an initial 30 day period in which you can change your mind for a full refund. After that time, dues will be assessed annually. There will be no partial refunds given if withdrawal occurs mid-year. If you should decide to discontinue your Membership with SWBHIPA, you will be terminated from the SWBHIPA contracts. You will need to reapply and negotiate a direct contract with any of the insurance companies with which you want to continue participation.