UNICO is actively involved in developing and implementing pay-for-performance programs that provide financial rewards for high-performing physicians. The IPA board members and staff offer educational and advocacy opportunities created to assist IPA practices. The network management team communicates daily with health plans to resolve issues and provide training courses on policies and programs to meet future demands.
UNICO IPA provides constructive input in the managed care decision-making process at the highest levels. Our list of services include:
UNICO IPA’s Quality and Provider Outreach teams work with providers throughout the year on clinical documentation improvement, risk adjustment, quality gap closure, audit support, and claims reviews. Our successful track record of working with health plans and their vendors improves both clinical and performance outcomes with chart review and collection.
UNICO IPA was established with a reputation for integrity and honesty. Our relationships with our members are built on trust earned over time through experience.
We strive to operate our business ethically and in full compliance with applicable federal and state regulations, including but not limited to The Health Insurance Portability & Accountability Act (HIPAA). We provide compliance education and guidance of compliance program implementation for our members to help them meet the Medicare and Medicaid compliance program requirements and fulfill compliance-related terms with our business partners. UNICO IPA promotes open and clear lines of communication to report compliance and ethical concerns of fraud, waste, and abuse or other violations of company policies, without retaliation or intimidation.
UNICO IPA places the overall interests of our providers first in all contract decisions.
The Contracting Department works closely with our business partners. From health plans to hospitals to laboratories. Our careful examination of key contract elements, such as language, reimbursements, range of quality incentives, and your matrix of responsibility ensures the highest possible economic benefits for UNICO IPA providers.
UNICO IPA will work with our members to ensure that all necessary documents are in place and submitted for credentialing with our contracted payers.
We strictly adhere to compliance with the National Committee for Quality Assurance (NCQA) and health plan standards. We take every precaution, utilizing state-of-the-art technology to ensure our network is secure, reliable, and protected. Data is secured to ensure confidentiality, HIPAA compliance, and disaster recovery. The Credentialing Department maintains a proprietary physician database and can offer a quick turnaround time of 24 hours of processing time when required. We are also available for your convenience in completing credentialing applications quickly and securely.
UNICO IPA Disease Management is dedicated to preventing and treating illnesses and enhancing the greater health of individuals, families, and communities of Asian Americans. Our core Diabetes Self-Management Education and Support (DSMES) Program is designed to improve the health and well-being of patients with diabetes through improved self-care behaviors in a cost-effective manner. What else can DSMES do for you?
UNICO IPA has a team of technical professionals to help our members implement and adopt new technologies.
The IT Department combines the latest hardware and software to ensure efficiency and accuracy of data gathering and statistical reporting. IT provides ongoing training and technical support to all providers and their staff and providers who utilize our online applications.
UNICO IPA has always been focused on helping our provider members optimize their revenue and improve their workflow in an ever-changing healthcare environment. The Point of Care (PoC) platform is one of UNICO IPA’s latest innovations to help streamline the provider and their staff’s access to content, which results in better decisions, better care, and better financial outcomes. The PoC platform provides patient-specific information to enhance health care. The platform encompasses a variety of tools to enhance decision-making in the clinical workflow. The PoC programs offers additional benefits, including:
Our team develops strategic plans that utilize various communications channels and collaborates with providers, partners, and managed care plans in the healthcare community to support UNICO IPA’s mission.
We also create, support, and deliver marketing programs to grow and expand the UNICO IPA patient base and provider services through outreach events. Other responsibilities of our team include:
The primary goal of UNICO IPA Network Management is to improve quality and clinical excellence for our providers and patients and to allow providers to practice medicine with little or no administrative burden.
This is done through daily functions performed by UNICO IPA staff, such as liaison between health plans and doctors to claims issues, overpayments and recovery, audits, vouchers and demographic updates. We actively negotiate with the VBP’s health plans. UNICO IPA will simplify the resolution of these issues and eliminate barriers to providers through designated health plan representatives.
UNICO IPA employees provide resources when our providers and their employees encounter difficulties accessing programs. While most cases are handled by health plan representatives, it is sometimes appropriate to utilize UNICO IPA to attract health plan managers who focus on key issues that affect IPA practices.
Our knowledgeable and professional staff is committed to supporting and educating doctors about managed care policies. They are strategically assigned to physicians in our IPA network to ensure efficient communication and to assist physicians and office workers in the following areas of operation.
The Care Coordination program is a safeguard designed to keep our patients healthy. Our program is staffed with physicians, physician assistants, nurse practitioners, nurses, social workers, and medical assistants.
Our transitional care management and chronic care management team works closely with community physicians to monitor patient traffic (focusing on admissions, discharges, and ER visits) with our chronic and high-risk patient population. This allows us to capture and prevent the progression of ambulatory sensitive and chronic
conditions. Care coordination is the keystone to our organization, allowing us to keep our patients healthy while fostering an intimate patient relationship.
The home health assessment program is an added benefit for patients under our UNICO IPA umbrella, intended to close the gaps in care, but not replace the care provided by their primary care physician. We provide an annual medical assessment to qualified patients. This service is furnished by licensed medical providers also known as Advance Practice Providers (APP), such as Physician Assistants (PA) and Nurse Practitioners (NP).
The assessment encompasses a broad range of medical, social, and psychological evaluations, which includes but are not limited to the optimization of medical diagnoses, medication reconciliation, depression and anxiety screening, cognitive assessments, activities of daily living (ADLS) assessments, nutritional surveys and social assessments. Any unaddressed needs that are identified through our assessments are directed to the appropriate resources, such as case managers or the patient’s primary care physician. The overarching objective of the program is to identify missed gaps, monitor chronic illnesses, and improve the accuracy of the patient’s diagnosis. Our service, in addition to our case management, further assists our PCPs efforts in maintaining and improving the health of our patients.
Changes within the healthcare landscape have created layers of administrative hurdles for our physicians. Free yourself of administrative burdens with our Individualized Physician Management, which was designed to allow our doctors to be doctors. As large healthcare systems continue to jeopardize the existence of solo and small private practices, it is in our core DNA to maintain the independence of our physicians. We provide a spectrum of services such as, but not limited to: practice management, ancillary clinical support, human resources support, information technology support, billing and coding, and maintenance. Creating an environment that is sleek, innovative and moder allows us to remain competitive to attract healthcare professionals to care for the people in their community.
Provider Engagement consists of Account Executives who work closely with UNICO IPA providers and their office staff to improve quality and financial performance. Other team responsibilities include:
The Account Executives engage practices pertaining to provider performance and operational excellence, including: financial performance, incentive programs, quality and clinical management, population health data sharing, connectivity, documentation and coding, HEDIS and STARs performance, and operational improvements.
Provider Relations at UNICO IPA is committed to our network physicians and their office staff.
Our knowledgeable and professional team works to support and to keep our providers informed of current managed care policies. They ensure the greatest communication and work hands-on to assist physicians and office staff in areas, such as:
The UNICO IPA Quality Team strives to support UNICO IPA providers in delivering high-quality and efficient care. Through education, outreach and chart review, the Quality Team helps providers excel in performing necessary preventative care and quality measures, which improve outcomes and reduce cost.
The Quality Team also performs functions in prospective and retrospective risk adjustment programs, which assist providers in capturing conditions or diagnoses that may have been missed. With outstanding patient care, unrivaled accessibility, and support from the Quality Team, UNICO IPA physicians consistently rank among the top quality providers with health plans.
202 Canal Street
Suite 500
New York NY 10013
Tel: (212) 965.9888
Fax: (212) 965.1876
info@unicoipa.com
