Administrative Services

MedPOINT Management provides the administrative services related to Utilization Review Services, Claims, Eligibility, Health Plan Benefits, Quality Management, Grievances and Provider Relations.
Global Care Medical Group IPA Managed by MedPOINT Management. We Make Managed Care Manageable

PROVIDERS HAVE RIGHTS!!

Participating Providers have the right to request a review of the information obtained from primary sources during the credentialing process (e.g. malpractice carriers, state licensing boards, National Practitioner Data Bank). If you suspect any erroneous information is contained in your credentialing file and you would like to request a review, please contact Ann McMunn, Credentialing Supervisor, at 818 702-0100, extension 247 for details.
As always, it is MedPOINT Management's standard to immediately inform participating providers should information received in the credentialing process vary substantially from the information supplied by the provider

MedPOINT MANAGEMENT IS HERE TO HELP!

Please inform us of your scheduled Facility Site Review with L.A. Care. As you know, one of the criteria for maintaining your status as a participating provider with contracted health plans is a satisfactory score in both medical records and facility operation. If you participate in the Medi-Cal Managed Care Program, this includes criteria considered Critical by LA Care Health Plan and its Plan Partners. Overall scores <80% or a Critical Criteria score <90% on a L.A. Care Health Plan Facility Site Review will effectively close your practice site to new enrollment until you have successfully completed the Corrective Action Plan as outlined by LA Care's description of deficiencies. Please contact the Quality Improvement Department when you receive notice of LA Care Facility Site Review. Should you need assistance in preparing prior to the LA Care visit or in the implementation of a Corrective Action Plan, we can schedule a time for a Quality Improvement Specialist to make a visit to your practice site. The Quality Improvement Department can be reached at 818 702-0100, extension 231 or 247.

PM 160 INF QUICK TIPS

As you probably know by now, these is a state timeliness requirement for PM 160 INF forms. The PM 160 forms are due to the health plans by the 10th day of each month for the previous month's CHDP services.This means that MedPOINT must receive the completed forms by the 3rd of each month. Please note: Health Net has pre printed forms that can be submitted directly to them and they do not need to be routed to MedPOINT. Supplies of these forms will be sent to your office soon so the process can be expedited. There are a few quick tips to follow when filling out the forms:

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FEE FOR SERVICE (FFS): All FFS requests go through Global Care Medical Group IPA

✅All non‐emergent requests for these services shall require authorization prior to scheduling. The
requesting physician shall submit these requests through Global Care Medical Group IPA via the
MedpointManagement.com provider portal.

✅Once authorization has been obtained, Global Care Medical Group IPA will send the authorization to
the indicated imaging center, which will then contact the patient for an appointment

AFFILIATED HOSPITALS
AFFLIATED HOSPITALS PLANS
*Southern California Hospital at Culver City
*Southern California Hospital at Hollywood
*Los Angeles Community Hospital at Los Angeles
*Los Angeles Community Hospital at Norwalk
*Southern California Hospital at Van Nuys (behavioral health)
*Los Angeles Community Hospital at Bellflower (behavioral health)
Adventist Health White Memorial
Los Angeles Community Hospital at Norwalk ^
Adventist Health White Memorial Montebello (Beverly Hospital)
Martin Luther King Jr. Community Hospital
Adventist Health Glendale
Memorial Hospital of Gardena
Alhambra Hospital Medical Center
Monterey Park Hospital
California Hospital Medical Center *
Pacifica Hospital of the Valley
Centinela Hospital Medical Center
PIH Health Downey Hospital
East Los Angeles Doctors Hospital
Providence Little Company of Mary – San Pedro & Torrance
Garfield Medical Center
San Gabriel Valley Medical Center
Greater El Monte Community Hospital
Southern California Hospital at Culver City *^
Hollywood Presbyterian Medical Center *
Southern California Hospital at Hollywood ^
Lakewood Regional Medical Center
St. Francis Medical Center
Long Beach Memorial Medial Center / Miller Children’s Hospital
St. Mary Medical Center
Los Angeles Community Hospital at Los Angeles ^
Valley Presbyterian Hospital
Legend: * - Dual Risk for Medi-Cal Health Net
^ - Dual Risk for Medi-Cal Blue Shield Promise & LA Care with Alta Hospital Systems

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