A Low Risk Pricing Structure

Pricing for a UPA Membership is divided into two broad phases: the Evaluation Phase and the Full Member Phase. Full Members can choose between two options: the Value Option or the Equity Option.

UPA never charges setup fees, transaction fees, cancellation fees, or other hidden fees, and you are always free to cancel your membership with just 90 days notice.

Evaluation Phase

During the Evaluation Phase, you pay just $1/month for one year to gain provisional access to UPA data and decide if you feel there is sufficient benefit to you to continuing to practice with UPA. For physicians to join UPA, we recognize that there is a cost to perform due diligence. To encourage prospective physicians to assume that cost (ultimately to generate strength in numbers), UPA charges just a nominal fee -- $1/month -- for the evaluation phase of your membership. 

Full Member Phase

If you determine that your practice can see real value in a UPA membership, we complete the legal paperwork that allows you to enter the Full Member Phase and you begin submitting claims at UPA rates. During the Full Member phase, fees are separated into two components:

  • Collections Reconciliation Fee, and
  • Administrative Fee

Collections Reconciliation Fee

In order to perform the real work required to accurately reconcile all the funds which come in under the UPA tax ID number, all Full Members are subject to a Collections Reconciliation Fee from zero to 0.5% as outlined below. As you become a Full Member (so that we can improve patient care and negotiate together), there is a legal requirement to bill 75% of your medical work under the UPA tax ID number. When multiple physicians bill under a single tax ID number, insurance companies send all remitted funds to only a single location, an occurrence which poses some reconciliation challenges. 

What differentiates UPA within the marketplace is that UPA has developed proprietary software which enables the accurate reconciliation of funds when multiple physicians under multiple systems bill under the single tax ID number. Of course all billing must be consistent with UPA’s policies and procedures (which is very similar to what you already do), and the software system must be ANSI compatible (which all accredited systems are). UPA believes that when physicians can maintain control of their own billing, more physicians will join, and we all will generate greater strength in numbers.

There are two basic ways in which you may bill under the UPA tax ID number: 

  • You can continue to do your billing largely how you are presently doing it, in coordination with UPA’s collection reconciliation procedures at a 0.5% charge. 
  • You can move your billing and collecting in its entirety to UPA Management Services, LLC or one of UPA’s contracted practice management providers. (For practice management companies interested in becoming UPA contracted providers, please Contact Us here.) The fee for those services would be specialty specific and would be no greater than either the fee you are currently paying - or 8% of collections - and there would be no additional collections reconciliation fee.

Administrative Fee

As a Full Member of UPA, you will choose between two options, Value or Equity, each associated with different fees and different benefits. The Value Phase is less expensive and varies as outlined below. The Equity Phase provides for the building of equity in UPA as UPA grows. 

Value Phase

Full members can choose to minimize their capital outlay by joining under the Value Option - in which the UPA administrative fee begins at just $25/physician/month and increases only if:

  • UPA increases your revenue through higher reimbursement rates, or
  • UPA diminishes your expenses through lower overhead costs, and
  • UPA demonstrates this to you, and gives you 30 days notice.

The administrative fee would never exceed $500 per month. When UPA is able to justify an increase in the administrative fee up to $500 per month (by demonstrating an increase in your revenue or a decrease in your expenses totaling more than twice the adminstrative fee), then full members could choose the equity option and begin accruing equity rights in UPA. 

Equity Phase

Full members can choose to fully support the mission of UPA upon entry, and immediately begin accruing equity rights in UPA by joining under the Equity Option - in which the UPA administrative fee is $500/physician/month. With UPA's growing strength in our ability to negotiate on behalf of the physician membership, we expect to be able to justify an administrative fee of $500/physician/month, and this fee is the ceiling.  If you are willing to incur this administrative fee, then you will be eligible for a preferred equity option. (See Equity Membership, and Be a Founding Member.)