Who and What is Academy?

Academy IPA was formed 18 years ago by a group of O&P and DME providers who realized that if they join together and operate as a group they will have more clout with the insurance companies, thus increasing their bottom line, while at the same time, benefiting the insurance companies by offering them a one stop shop, where they can send ALL their patients for service. This, of course benefits the patients as well, creating a win-win situation. Over the past decade, Academy has expanded by allowing other providers to join the group.

What benefits can I expect by joining?

By joining Academy IPA, the member will have access to close to 70 health plans many of which they would not have otherwise. Additionally, the member can expect increased traffic to their facility, either thru our referral service fed to us by the insurance companies or by the patient finding your location on our online search tool.

In addition, Academy scrubs all claims weeding out the errors resulting in less denials. Furthermore, our expert staff will challenge every improper denial, resulting in you getting paid sooner and higher while saving the member the time and money it would’ve cost them if doing it on their own.

What is the relationship between Academy and its members?

Members who join the group are considered as partners in the group and vice versa. the terms of the partnership is outlined in the contract. However, the extent of the partnership only extends to patients serviced by the group.

What are the requirements to join?

First and foremost, the members facility has to be accredited by one of the major accreditation entities. The service provided has to be of top quality and the practice must adhere to the utmost diligence in following all the proper guidelines. In addition, membership is limited to a certain amount of providers per geographical areas. Thus, if a practice has many locations, not every location is automatically enrolled.

The quality of the service provided, the practices competence and the patients interests are the main factors in deciding whom Academy accepts as a partner.

What fees are associated with participation in Academy?

Unlike other groups who charge a sign up fee, or yearly fees. Academy’s revenue is derived from the individual claim, where Academy keeps a small fee from each claim, the exact details are outlined in the contract.

What is the process for joining the group?

The member can fill out the contact form or call our office and someone from our staff will contact you and set up a site visit review the contract, and offer the member a determination within two weeks if their application to join is accepted.

If my practice has many practitioners, does everyone need to apply?

No. Since the membership status is based on the company,  the owner can apply on behalf of all his practitioners. However, the credentials of each practitioner need to be provided to us.

Is a member expected to bill all of their claims thru Academy?

Of course not. Unlike other groups, who insist that all of your claims need to be processed thru them. Each partner has full control as to which insurance plans they want Academy to handle for them and the partnership extends to those claims only.

Does Academy offer authorization services as well?

Only if the member chooses to, for a 3% fee. Otherwise, the provider is expected to get the authorization on their own, we take over after delivery.

Does Academy make any determination with regards to reimbursement?

Academy adheres to all guidelines in place by the insurance plans and we do not deviate from it. However, if Academy has a legitimate concern with regards to a delivery or service, we reserve the right to withhold payment until we are satisfied that all the i’s are dotted and all the t’s crossed.

What is the turnaround time for Academy to process payments.

Of course it depends on the volume of payments received by us on any particular day/week, since we manually review every single payment before we close it.  However, generally the member can expect to get paid by the end of each week for payments received thru Tuesday of that week.

Does Academy provide EOB’s to its members.

A copy of each individual EOB is forwarded by email to the member, where the member can clearly see the exact details of the reimbursement.

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