Why Building a Patient Panel is Harder Than It Looks 

Alina Mineyli, Credentialing specialist at WCH 

Recently, one of our clients approached us with a concern. After joining an IPA and securing a capitated basis contract, the provider enrolled with several insurance plans and, over time, noticed they were not receiving the expected incentive payments as a PCP. Under the capitated arrangement—according to the specific line of business—the provider is supposed to receive a per-member fee for each attributed patient, regardless of whether a visit occurred. However, no incentive payments were received. 

The Numbers Game: What Solo Practitioners Need to Know