Information about

Our Services

Please click below for details regarding the services we provide for Claims, Contracting, Credentialing, Customer Service, Finance, Health Education, Provider Relations, and Utilization Management.

Claims

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

Office Ally payer ID:

  • IN Physician Associates IPA: INPA1
  • 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 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 Contracting Department carefully examines key aspects of each contract to protect our managed groups and patients’ best interests. Interested in joining our network? Please send your inquiries to contracting@imsmso.com.

Credentialing

IMS offers credentialing and re-credentialing for providers and facilities. The team conducts monthly monitoring of the network and maintains records to ensure all expiring documents remain current and up to date. IMS can assist with provider directories and work as the liaison between the payers and physician groups to ensure all changes to the network are updated within contracted time frames.

IMS works directly with CAQH, a NCQA accredited Credentialing Verification Organization and national self-attested Provider Database, housing one million completed records across the nation. If you are looking to build a network or join a network, utilizing CAQH can help expedite the process and save on administrative efforts. Most payers will accept the CAQH application in lieu of their Credentialing application. This means that participating Providers will never have to complete another Credentialing application again, reducing administrative burden.

Don’t have an account with CAQH? IMS will help you create one if you don’t have the 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 a non-biased diverse group of Providers contracted with IPAs managed by IMS for peer review. 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 expirables and daily sanction monitoring.

Customer Service

IMS provides extensive training to our Customer Service team to equip them with the knowledge and tools needed to offer meaningful and positive member and provider experiences. Our team takes full advantage of each opportunity to speak to a provider, member, caregiver, or family member by using motivational interviewing techniques to better understand the reason for the call, and to successfully resolve issues on the spot. Our Customer Service application was strategically selected to offer additional information to our Customer Service representatives. This provides our team with a complete view of each caller, to assist in addressing the member or provider’s outstanding needs. Our Customer Service team will always go the extra mile for each call to ensure that every caller feels valued and important.

Our Customer Service team is equipped to provide the most up-to-date member information to our physicians who are calling about Eligibility. Our Customer Service team and online Provider Portal will offer Primary Care Physicians (PCP) real time eligibility lists and reports regarding Health Risk Assessments (HRAs).

Questions?  Please use our chat button (located at the side of this page) to speak to one our Customer Service Representatives, Monday – Friday from 8:00 – 5:00 PM PT.

Finance

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

Health Education

IMS’ goal is to promote a healthy lifestyle and to offer preventative health education referrals to Providers. Our Health Education services encompass various areas such as physical, emotional, and spiritual health, which may include, but is 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 our Customer Services team at 323.800.8283 or email providerrelations@imsmso.com.

Provider Relations

IMS’ Provider Relations team works 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 Provider Portal’s advanced features ensure that Providers stay up-to-date with all of the latest information, have the ability to self-manage their accounts, and receive real-time status updates on authorizations and claims.

IMS’ Provider Relations team can 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 for prior authorizations and hospital clinical review, which will allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing the appropriateness of the benefits against evidence-based guidelines/criteria before they are provided.

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