Information about

Our Services

Please have a look at the services we provide for Claims, Contracting, Credentialing, Customers, Finance, Health Education and Provider Relations.

Claims

Practitioners are encouraged to submit claims electronically through OfficeAlly or through our Provider Portal.

Office Ally payor ID:

  • Northern California Physicians IPA: NCPG1
  • All United Medical Group IPA: AUMG1

Hard Copy CMS 1500/UB04
Mail Claims:

6119 E. Washington Blvd., Suite #201,
Commerce, CA 90040

PDR: 120 days from initial payment determination.

Provider Portal: can be used to check status on claims. Please log on by clicking here.

Contracting

Innovative Management Systems’ Contracting Department serves as an integral role in network management. Services include building, expanding, and maintaining a comprehensive physician and ancillary provider network to ensure that all necessary services are available to the patient population. Our contract team carefully examines key aspects of each contract, in order to ensure the best possible interest for our managed groups and patients. Interested in joining our network? Please send your inquiries to contracting@imsmso.com.

Credentialing

IMS works directly with CAQH, a NCQA accredited Credentialing Verification Organization and a national self-attested Provider Database, housing one (1) Millions completed records across the nation. If you are looking to build a network quickly, or join a network quickly, CAQHA is your answer. Most payers will accept the CAQHA application in lieu of their Credentialing application – meaning Providers will never have to complete another Credentialing application again, saving the Provider administrative burden. Don’t have an account with CAQH? IMS will help you create one if you don’t have time. Simply email our friendly Credentialing Specialists at credentialing@imsmso.com to obtain assistance or visit CAQH to register your account. You can also re-attest to your existing account and/or provide IMS access to your account if global access wasn’t already provided.

The Credentialing Committee is comprised of a representation of Providers who are contracted with the various IPAs managed by IMS. The Credentialing Committee meets on a monthly and ‘as needed’ basis to review the completed files and to make appropriate recommendations to the Boards. IMS also provides continuous monitoring of all expireables and daily sanction monitoring.

Customer Service

IMS offers extensive training to their customer service team so they are equipped with the knowledge and tools needed to offer meaningful and positive member and provider experiences. Taking full advantage of each opportunity to speak to a provider, member, caregiver or family member our staff uses motivational interviewing techniques to better understand the reason for the call to be able to successfully resolve issues on the spot. Our customer service application was strategically selected to offer additional information to our customer services reps allowing them a 360 view of each caller to capitalize on any outstanding needs the member or provider may have.

The Customer Service team is equipped to provide the most up-to-date member information to our physicians calling for Eligibility. The Customer Service team and our online Provider Portal will offer Primary Care Physicians (PCP) real time eligibility lists and reports regarding Health Risk Assessments (“HRAs”). Our Customer Service Team goes the extra mile with each call to make every caller feel valued and important.

Questions?  Please use our chat button to speak to one our Customer Service Reps, located at the side of this page, Monday – Friday from 8-5pm.

Finance

The Finance Department offers financial accounting, accounts payable and receivable management, financial and regulatory reporting, revenue reconciliation and the preparation of the internal financial functions for our internal clients.

Health Education

IMS’s goal is to promote a healthy lifestyle and to offer preventative health education referrals to Providers. We have partnered with organizations in our community to provide members with quality health education classes and materials to achieve and maintain healthy lifestyles and promote positive health outcomes. Health Education services encompasses various areas such as physical, emotional, and spiritual health; including, but not limited to individual counseling, written information, and/or group classes at no cost to the member.

For a complete list of services offered near you, please call Customer Services at 323.800.8283 or email providerrelations@imsmso.com.

Provider Relations

The Provider Relations Team at Innovative Management Systems work to support and keep our physicians current with managed care policies. By providing management services that assist providers with the administration of their practice, physicians can focus their attention solely on providing high quality care to their patients. Our advanced features of our Provider Portal ensure Providers stay up to date with all the latest information, have the ability to self-manage their accounts, and receive real time status updates on authorizations and claims.

Provider Relations assist physicians and office staff in the following areas of operations:

  • New Provider Orientation; Office Staff Training
  • Routine on site visits to meet with physicians and office staff
  • Web Portal & Other Web Based Meetings
  • Solutions for utilization management, claims, capitation, eligibility, quality improvement, reimbursement, and other network operations areas
  • Quality/HEDIS/STAR measures resources
  • Compliance education and materials
  • State, Medicare, and/or Health Plan policy updates
  • Assistance with any demographic changes

Interested in adding a Provider or looking to join the network contact our Contracting Department at contracting@imsmso.com.

Utilization Management

Utilization management or utilization review is the use of managed care requirements related to prior authorization, hospital clinical review which will allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its appropriateness before it is provided using evidence-based guideline criteria.

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