Welcome Providers

InterWest Health is a preferred provider organization (PPO) doing business in Montana, Idaho, Washington, North Dakota, South Dakota and Wyoming. It is the largest, most comprehensive PPO network available in the region, consisting of over 15,000 participating hospitals, physicians and other providers.

InterWest is widely used by insurance companies, TPAs and other payors as a way to make their health benefit plans more competitive and affordable. Today, over 170,000 people are covered under health benefit plans that utilize the InterWest PPO network.

InterWest is different from other PPO networks in that it is not aligned with a particular hospital or insurance company. It is an independent organization aimed at giving payors access to quality health care services at competitive prices under contract terms that are responsive to the needs of the local medical community.

Participating Provider Agreement

InterWest Health’s Participating Provider Agreement is a state-of-the-art contract that was developed with input from physicians and other providers. It has been reviewed by state medical societies and other organizations and is considered to be one of the most provider-friendly contracts available.

InterWest offers a fair and reasonable level of payment to all participating providers that compares favorably to other payors in the local marketplace. Physicians and other practitioners are paid on a fee-for-service basis according to maximum allowable fee schedules or discounted charges. Hospitals and other facilities are paid on the basis of individually negotiated discounts, per diems or per case rates.

There are no dues or fees that participating providers must pay to participate in InterWest. Providers may terminate their participation at any time, for any reason, with 90 days advance written notice.

InterWest is endorsed by the Montana Medical Association.

How to Join InterWest

To join InterWest Health's PPO network, providers need to complete a Provider Application form and send it to InterWest, along with a signed Participating Provider Agreement. The application will be reviewed to make sure the provider is in compliance with the company’s credentialing standards. Once this review is completed, the Agreement will be executed, with a copy returned to the provider.

Participating providers are credentialed according to standards based on NCQA and URAC guidelines. Providers are credentialed initially at the time of enrollment and every 3 years thereafter.

The Participating Provider Agreement is a standard agreement which applies to all types of providers, including both physicians and hospitals. The only part that varies between providers are the Network Participation and Compensation Schedules attached to the back of the Agreement. For physicians and other practitioners, a common set of schedules are used which document InterWest’s standard fee schedules for professional services. For hospitals and other facilities, the Schedules are customized to reflect the payment rates that are individually negotiated.

Providers who practice in a group setting may participate in InterWest under one Agreement, as long as they are covered under the same Tax ID. A completed application will need to be submitted for each participating provider for credentialing purposes.

Hospitals and other large groups who have established credentialing programs may assume local responsibility for credentialing, as long as their programs are compatible with InterWest’s credentialing standards. Groups who want to do their own credentialing may sign a Delegated Credentialing Amendment, which relieves them of the obligation to fill out individual applications and submit credentialing information. All that is needed to enroll the group is an abbreviated set of demographic data, which is conveniently supplied by way of a Provider Add Form.

Providers interested in joining InterWest can obtain copies of InterWest’s Provider Application form and Participating Provider Agreement from this website or by contacting InterWest at (406) 542-1912 or toll free at (877) 542-1912. Providers practicing in Idaho, Washington and other states that utilize standard application forms are welcome to use those standard forms in place of the InterWest Provider Application.

Benefits of Participation

InterWest Health is a preferred provider organization that strives to be of service to its Participating Providers by negotiating contracts with payors that are responsive to the needs of the medical community.

Some of the benefits of participating in InterWest's PPO network include:

• Provider-friendly contract developed with input from physicians and other
  providers and endorsed by the Montana Medical Association
• Fair and reasonable level of payment that compares favorably with other payors
• No fees or dues to participate
• Right to withdraw from the network at any time, for any reason, with 90 days notice
• Friendly, responsive service, including dedicated support to resolve EOB and
  other issues with payors
• Access to InterWest’s contracted payors, representing over 170,000 enrollees in the service area
  

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