FAQ Frequently Asked Questions

Created by Allen Santos, Modified on Wed, 28 Jan at 8:41 AM by Allen Santos

What is SIPA Physicians business address?
9 N Loudoun St Ste 103
Winchester, VA, USA

Phone (540) 722-1111
Fax (540) 722-3535

Which payors do you contract with on our behalf?
Aetna
Cigna Value Based Care
Privia (formerly Evolent) Value Based Primary Care
Humana Value Based Care
MedCost (formerly Virginia Health Network)
Sentara (formerly Optima and Virginia Premier)
The Health Plan
Peak Health - Valley Health Employees
Physician Services (formerly Zelis | 4 Most | Stratose)
Do you negotiate fee schedules, value-based contracts, or both? Yes, we do both
How do your rates compare to independent negotiations? Honestly, hard to say given the payors don't share that information. Providers tell us our rates are better.
Are there guaranteed rate improvements, or is it “best effort”? It's NEVER a guarantee, no matter what anyone says.
How often are contracts renegotiated? If our providers give us feedback, we will approach the payor. Because our group is so diverse, SIPA renegotiates very carefully.
What level of control do we retain over payer participation? This is a messenger model. The practice retains opt in opt out control.
What decisions must go through the organization vs. remain local? Generally SIPA steps in if you're having issues with payors.
Are there clinical protocols, pricing, staffing, or vendor mandates? No. SIPA is looking to offer these services on a a-la-carte basis.
Do you restrict ancillary services, aesthetics, or cash-pay offerings? No. BUT we might if the payors require us to.
Can we opt out of specific programs or initiatives? The practice always retains the option to Opt Out
Who owns patient data and analytics? The practice owns the data. Generally the Payors share the analytics with SIPA for clinical quality improvement.
What is the implementation timeline? The credentialing process can take up to 60 days
Are there penalties or fees to exit? No penalties to exit. If a provider leaves before 3 years (or full share purchase), the dues paid are forfeit to SIPA Physicians.