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Billing & Reimbursement

Overpayment impacting January 2019 capitation and PCP quality incentive payments for panels with Keystone 65 Focus Rx membership only 

January 7, 2019    

Independence has identified errors impacting January 2019 capitation and PCP quality incentive payments with panels containing Keystone 65 Focus Rx membership. Monthly capitation and incentive payments that will be issued to your practice by January 10, 2019, will be affected by the following issues:

  • your practice’s commercial membership panel will erroneously also include the Keystone 65 Focus Rx members attached to your panel, causing an overpayment;
  • an incorrect rate will be attributed to your practice’s Keystone 65 Focus Rx membership causing an overpayment.

Next steps

We are working diligently to correct the issue and will be retroactively adjusting the overpayment as permitted under the terms of your Independence provider agreement in a future capitation or quality incentive payment. Prior to making the retroactive payment adjustment, we will send out a communication for your practice to be prepared.

For more information

We apologize for any inconvenience. If you have questions about how your practice’s capitation payments are affected, please contact Independence by emailing pcprequests@ibx.com or specialistsrequests@ibx.com, as appropriate.

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