Pacific Partners Management 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 groupís 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

Network Management & Provider Relations
NCQA Credentialing
Financial Management
Utilization and Case Management
HIPAA Compliance
Quality Initiatives

Medical Group Management
> Eligibility
> Capitation Management
> Provider Fee Schedule Maintenance
> Benefit Maintenance
> Claims Management
> Encounter Data Management
> Customer Service (claims)
> Insurance Services (Stop Loss, COB, TPL)
> Decision Support & Data Analysis
> Information Technology and Solutions
NCQA Certified
Responsible Disclosure
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