SOMOS Innovation–OG
Picture of Somos Innovations
Somos Innovations

Innovator Quality Bill Above Program

At SOMOS Innovation, we value everything you do to deliver quality care to your patients and ensure they have a positive health care experience. To recognize pediatricians, internists and family practice physicians who collaborate with us to provide superior care to our members, SOMOS Innovation is excited to announce the Innovator Quality Bill-Above Program. 

Effective July 1st 2022, SOMOS will increase the payment for select codes to support quality improvement. This is in addition to the capitation you receive under your current Participation Agreement.

Innovator Quality Bill Above Program

Child & Adolescent Well Visits

Innovator Quality Bill Above Program

Attention Billers – Reimbursement Process:

In 2022: 

  • Claims/Encounters will be reviewed for processing on a monthly basis starting July 2022 retroactively to Jan 1, 2022
  • Payment will be processed monthly basis effective July 2022 with an explanation of payment of claims submitted
  • Timely filing and standard claims policies may apply


Beginning January 1, 2023

  • Reimbursement will be administered through a standard biweekly claims payment process
  • Practices continue to submit claims/encounters with appropriate coding