Setting Up Aligned Marketplace

Aligned Marketplace is a national marketplace that connects employer-sponsored members from large, geographically dispersed organizations with direct primary care practices. Through a single agreement with Aligned, your practice gains access to a growing member base across multiple employers without negotiating individual contracts or incurring patient acquisition costs. When a member establishes care with your practice, Aligned pays your practice directly at your monthly "employer rates," without any fees.

Setting up Aligned in SigmaMD has two parts:

1. Get connected. Your practice contracts directly with Aligned, and Aligned then asks SigmaMD to turn on the free integration for your practice.
2. Set up the Aligned employer. Once your practice has contracted with Aligned and is connected, you add Aligned as an employer, turn on Share utilization data, create a membership plan, and send Aligned an enrollment link.

Before You Start

• A practice Admin. Only an Admin sees the Aligned Marketplace card and can complete the steps below.
• A practice email on file. Your practice can't be connected if neither the practice nor its responsible user has an email address.

Step 1: Get Connected to Aligned Marketplace

1. Go to Practice Settings › Integrations.
2. On the Aligned Marketplace card, click Get started. Aligned's provider page opens in a new tab.
3. Register your practice on Aligned's site. If your practice is already registered with Aligned, contact your Aligned account manager instead and ask them to enable the SigmaMD integration.
4. Aligned lets SigmaMD know, and your practice is connected. The card then shows Active and Account connected.

Connecting doesn't turn on API Access and doesn't require the API license.

Important: being connected doesn't share anything with Aligned yet. Aligned only sees members of employers that have Share utilization data turned on (Step 3).

Recommended Setup for the Aligned Employer

Do these steps once your card shows Active. They're our recommendations, based on how practices already working with Aligned set things up.

Step 2: Create the Aligned Marketplace Employer

1. Go to Billing › Employers and click Employer.
2. For the company name, enter Aligned Marketplace.
3. Fill in the Address.
4. Under Company Administrators, add your Aligned account manager as the Primary contact. The primary contact needs a name, an email, and a phone number.

We recommend:

• Name it exactly "Aligned Marketplace." Aligned can see the name of every employer you share with it, so a clear name lets them recognize it. It also keeps Aligned members easy to find in your employer list and reports.
• Use one Aligned employer. Aligned members come from many companies, but you don't need an employer for each one. Put every Aligned member under this one employer.

Step 3: Turn On Share Utilization Data (Required)

In the same form, under Integrations, turn on Share utilization data. This section only appears once your practice is connected to Aligned Marketplace.

Aligned only sees members of the employers you turn this on for, so turn it on only for the Aligned Marketplace employer. Your other patients and employers stay private. The toggle is off until you turn it on, and if you skip it, Aligned cannot access utilization data for any of your Aligned members.

If you created the Aligned employer before your practice was connected, turn it on now:

1. Go to Billing › Employers and open the Aligned Marketplace employer.
2. In the left column, under Integrations, turn on Share utilization data.

Step 4: Choose the Other Employer Settings

Aligned pays you directly under your Aligned agreement, not through SigmaMD invoices. Because the Aligned plan is priced at $0.00 (Step 5), the contract and invoicing settings on the right of the form have no effect on what you're paid. We recommend leaving the defaults:

• Membership billing: leave In advance. It can't be changed once the contract exists.
• Invoice issue date, Due date, Autopay, and Prorate first cycle: no effect at $0.00.
• New patient start date: Variable starts each member's coverage on the day they enroll. Fixed day starts it on the day of the month you pick. We recommend Variable.
• New invoice is issued: you can leave this on. SigmaMD never emails a $0.00 invoice.

Click Save.

Each month the contract still closes a billing cycle. SigmaMD either skips the empty invoice or issues it at $0.00 and marks it Paid right away. There's nothing for you to do.

Step 5: Create the Aligned Membership Plan

1. Open the Aligned Marketplace employer.
2. On the Memberships card, click Create plan. The employer is filled in for you.
3. Enter a Plan name, for example Aligned Marketplace.

Seats. Employer plans follow three rules, and the plan won't save until they're met:

• The first seat must be named Primary.
• The Primary seat allows 1 member.
• The Primary seat must be required in every seat rule.

Add a seat for each type of dependent your Aligned agreement covers, with its Min age and Max age. For example:

• Primary: 18 and older
• Adult dependent: 18 and older
• Child dependent: 0 to 17

We recommend setting every seat's Monthly price to 0.00. Aligned pays your practice directly, so the plan exists only to track who your Aligned members are and share them with Aligned.

A member can only enroll if their age fits a seat. If it doesn't, the link shows: "Sorry, no enrollment options are available for this age group." Make sure your age ranges cover everyone Aligned may send you. If Aligned may enroll children without an adult, see Enrolling Minors.

For more on plan settings, see Steps to Create an Employer Membership.

Your Membership Agreement

Aligned staff fill in your enrollment link on behalf of their members, and they can't sign your membership agreement or office policies for a member. So the agreement stays off the Aligned plan, and each member signs it after they're enrolled.

Keep your agreement off the Aligned plan. A term set to Apply to all plans automatically covers the new Aligned plan. It then shows up on the enrollment link, and Aligned can't finish the enrollment. If none of your terms cover the Aligned plan, skip this.

1. Go to Billing › Settings › Enrollment Terms.
2. Edit each term. If it's set to Apply to all plans, turn that off and select only your non-Aligned plans. If it lists the Aligned plan, remove it.

Send it with the member's first appointment (recommended). Forms linked to an appointment type are sent to the patient automatically when an appointment of that type is booked.

1. Go to Practice Settings › Scheduling › Appointment types and open the type you use for first visits.
2. Under Attachments, add your agreement and office policies in Forms.
3. Turn on Exclude previously completed forms, so members who have already signed aren't asked again.
4. Optional: to send these forms only to Aligned members, make a separate first-visit type for them and, under Patient memberships, choose Selected memberships and the Aligned plan.

Or send it right after enrollment. If a member needs to sign before they book, open the member's chart, open their Aligned membership, and in the Enrollment Terms section click Add forms. SigmaMD emails the member a link to sign, and Resend pending forms sends a reminder.

Signed forms are saved to the member's chart. Your forms must already be published in Forms. See Attaching PDF Forms to Membership Terms.

Step 6: Create the Enrollment Link and Send It to Aligned

1. Open the Aligned Marketplace employer.
2. On the Enrollment Links card, click Create link. If the button is disabled with "Add a plan first", go back to Step 5 and make sure the plan is active.
3. Enter a Link name and a slug. The slug becomes the end of the link, for example yourclinic.sigmamd.com/signup/aligned.
4. Under Membership Plans, select the Aligned plan.

Employer links have no payment step and no start date to pick, because the employer covers the membership.

We recommend:

• Enrollment support: turn on Include phone number for enrollment support and Include email for enrollment support, and enter your practice's phone and email so members know who to contact.
• Expiration: leave Set link expiration date off, so the link keeps working for as long as your Aligned agreement does.
• Contact information: turn on Require email and Require mobile number so you can reach every Aligned member and send them your agreement. Collect address and Require address are up to you.
• Clinicians and locations: choose All clinicians and All locations unless your Aligned agreement covers only some. If only one is available, that step is skipped.

Once saved, the link appears on the employer's Enrollment Links card. Copy it and send it to your Aligned account manager. Aligned uses it to enroll its members at your practice.

If you change the slug later, the old link stops working. Send Aligned the new one.

What the Enrollment Link Shows

1. Select a plan.
2. Add Patients. The first person entered must be 16 or older, then anyone else is added.
3. Choose Location and Choose Clinician, unless only one is available.
4. Complete Your Membership Enrollment. With no terms on the Aligned plan, this step is just the Enroll button. There are no payment fields.

When the enrollment finishes, the link shows Enrollment Successful, and the membership appears under the Aligned Marketplace employer. The member then signs your agreement as described in Your Membership Agreement.

Disconnecting Your Practice

1. Go to Practice Settings › Integrations.
2. On the Aligned Marketplace card, click Disconnect.
3. Click Confirm.

Access is revoked immediately, and Aligned can no longer fetch utilization data. It's safe to click Disconnect again if you're not sure it went through. To reconnect later, contact your Aligned account manager.

Troubleshooting

Aligned Is Asked to Sign Your Agreement

Your agreement is still attached to the Aligned plan, so the link won't let Aligned finish until it's signed. Take the Aligned plan off your enrollment terms and have members sign afterwards. See Your Membership Agreement.

"Enrollment could not be started. Please contact the office for assistance."

The member's email or mobile number already belongs to a patient at your practice. A link can't create a second chart for them. Attach the Aligned membership from their existing chart instead. See How to Attach a Membership to a Patient and Enrollment Error When Using the Web Enrollment Link.

Enrolling Minors

• The person filling in the link must be 16 or older. If they're enrolling only children, they can check I am enrolling others, but not myself.
• Members under 14 must have a caregiver. The person filling in the link becomes their caregiver.
• Members aged 14 to 17 can be enrolled with or without a caregiver.

Every enrollment must fill the plan's Primary seat, and each member takes the first seat whose age range fits them. So if your Primary seat starts at 18, a child can't be enrolled on that plan without an adult. To let Aligned enroll a child on their own, create a second Aligned plan whose Primary seat covers the child's age (for example, Aligned – Child with Primary 0 to 17) and add it to the enrollment link. The link is then filled in with I am enrolling others, but not myself. checked, that plan picked, and the child added. See Guide to Signing Up Children for Pediatric Memberships.

"Share utilization data" Doesn't Appear

Your practice isn't connected yet. The section appears once your practice is connected (Step 1). If you've registered with Aligned and the card still doesn't show Active, check with your Aligned account manager that they've asked SigmaMD to enable the integration.

A Member Was Added to the Wrong Seat or Membership

Fix it from the member's chart. See How to Attach a Membership to a Patient.

Who to Contact

For any questions about setting up or using Aligned Marketplace, contact your Aligned account manager. That includes registering with Aligned, enabling the SigmaMD integration, your Aligned agreement, payments from Aligned, member eligibility, and utilization reporting.

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