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
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
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 TIPSAs 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:
Where We Are Going
Future of health care is moving towards more coordinated and appropriate care, shorter hospital stays and better care.
The subject of managed care is one that makes physicians and health care professionals very uncomfortable. The hard truth remains that deep public dissatisfaction with unfettered doctor and hospital autonomy led to the explosive growth of managed care. Managed care is driven by…
Posted in News | 15th September, 2017
| 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 |
TERTIARY HOSPITALS AFFILIATIONS
Urgent Care Center