900 E. Hamilton Ave, Suite 600 Campbell, CA 95008.

(800) 977-7478, (650) 358-5800

Services

Our Services

We are a full-service, Management Services Organization or "MSO" and are NCQA certified for credentialing and re-credentialing. Our core business is to administer all aspects of an IPA or medical group’s managed care delivery system. We are fully delegated by all major health plans to provide services including utilization management, quality improvement, credentialing, committee and board support, contracting with both health plans and providers, claims processing, provider and member services, marketing, IT support, and finance.

IPA / Medical Group Management
  • Eligibility
  • Capitation Management
  • Provider Fee Schedule Maintenance
  • Insurance Services (Stop Loss, COB, TPL)
  • Decision Support & Data Analysis
  • Information Technology and Solutions
    • Risk Management
  • Insurance Services (Stop Loss, COB, TPL)
  • HIPAA Compliance
  • Health Plan Audit
  • IT Audits
  • Risk Assessments & Remediation
  • Oversight and Management
    • Member Satisfaction
  • Happy Managed Members
  • Case/Care Management
  • Quality Care
  • Quality Initiatives
    • Delegated Services
  • Benefit Maintenance
  • Claims Adjudication, Management & Payment
  • Encounter Data Management
  • Customer Service (claims)
  • NCQA Certified Networks

    • Copyright © 1998-
    Pacific Partners Management Services Inc., a division of HCA Healthcare
    Terms of Use | California Notice at Collection | Privacy Policy
    Social Media Policy | Acceptable Use Policy | HCA Nondiscrimination Notice | Accessiblity | Disclosures