For providers
Join the network and keep your independence.
Marton Care IPA brings independent New York providers together for credentialing, health plan contracting and a public directory. You keep your practice, your patients and your billing: providers bill their payors directly.
Participation and credentialing fees
Provider participation and credentialing fees are waived until January 1, 2031. Any shared-savings arrangements and administrative fees payable by health plans to Marton Care IPA are separate from this provider fee waiver and governed by their applicable agreements.
Who can join
- Diagnostic and treatment centers (Article 28)
- Mental health providers (Article 31)
- Substance use disorder providers (Article 32)
- Licensed home care services agencies (LHCSAs) and certified home health agencies (CHHAs)
- Social adult day care centers
- Ambulance and EMS agencies
What participation includes
One credentialing file
The organization is reviewed and approved, and each practitioner is credentialed, with the evidence recorded for every decision.
Monitoring as part of the model
Review against exclusion and sanction sources is part of credentialing and ongoing monitoring, and any finding is reviewed before action is taken.
A contract option for each plan
For each health plan you choose between negotiated rates and plan-rate acceptance. Nothing takes effect without the plan’s acceptance.
A directory listing
Once approved you may be listed in the public directory, with a plan badge for each verified participation.
Two contract options
You choose which health plans to join through Marton Care IPA. For each plan or product, one of two downstream agreement options applies.
Negotiated rates
You propose reimbursement rates by applicable billing code. If the plan accepts them, the IPA submits your practice for network participation and completes the connection, subject to the plan approving the practice and the required onboarding. If the rates are declined and no alternative is agreed, the practice is not submitted or connected under that proposal.
Plan-rate acceptance
You accept the applicable plan rates through a pass-through agreement that references the identified rate schedule and version. The IPA submits your practice for participation with the plans you selected; the plan can still approve or decline the particular practice.
Under either option, participation requires agreement from both the plan and the provider. You may decline to join any particular plan. IPA membership or a signed downstream agreement does not by itself establish participation with every plan. Participation starts after the required approvals, completed agreements and the confirmed effective date.
Marton Care IPA is working to secure health-plan contracts using a value-based payment (VBP) model that includes shared savings.
What we ask of providers
- Complete the credentialing that applies to your organization and its practitioners.
- Keep your documents current.
- Report events within the deadlines your agreement sets.
- Cooperate with audits.
Start with a conversation
Email us to ask about joining. This begins an inquiry, not an application. Do not send patient information or credentialing documents by email. Contact us for approved submission instructions.