Northern California Physicians Group IPA


IPA NAME
SERVICING COUNTIES
Northern California Physicians Group
Santa Clara County

Northern California Physicians Group IPA

Provider Directory: https://quickcap.imsmso.com/provider_directory/index.php
Address:
13200 Crossroads Pkwy. N., #315, City of Industry, CA 91746
Phone:
(323) 800-8283
UM After Hours: (800) 285-6164


Health Plan managed by Innovative Management Systems MSO:

Submit claims to IMS electronically through Office Ally Payer ID: NCPG1

Portal: https://quickcap.imsmso.com/imsmso/general/index.php

  • IMS is responsible for Medicare Part B services’ claims, and both Part A and Part B authorizations.

Professional Component managed by NeueHealth:

Submit claims to NeueHealth electronically through Office Ally Payer ID: NEUEH

Portal: https://eznetedi.neuehealth.com/EZ-NET60/Account/Register.aspx

  • NeueHealth is responsible for Medicare Part A services’ claims.

Affirmative Statement

IMS employees who are in the position to review, conduct, or make medical decisions are not influenced by financial incentives, bonuses, or additional compensation relating to the quality of, access to, or utilization of Health Care services rendered to members. Physician reviewers are not rewarded for issuing denials of coverage. All decisions are reviewed using evidence-based guidelines, criteria, and/or the members’ Health Plan/IPA Evidence of Coverage.

To discuss denials, criteria, or to obtain an appeal, please call our Customer Service team at 323-800-8283.

Obtaining Decision Making Criteria

Clinical criteria related to Utilization referral decisions are available to Members, Providers, and the public, and may be requested by contacting the IMS Utilization Management Department, or via fax, portal, or by phone at 323-800-8283.  The criteria will be delivered within one (1) business day of the request.

IPA Attestation

References