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Quality Management

A comprehensive and integrated program that monitors and evaluates quality (STAR, HEDIS, HCC, Pay for Performance), appropriateness, and outcome of care.

Utilization Management

Trained professionals ensure consistent and quality care delivery. Please contact UM department for questions.

Provider Network Operations

Provider Services Department serves as a liaison between providers and the contracted health plans and ensures a complete comprehensive network.

Hospital Operations

Hospital Operations Department works closely with contracted hospitals to ensure quality and continuity of care for members.  

Case Management

Dedicated and trained staff, consisting of RNs and LVNs, are assigned to members with chronic conditions.

Claims Operations

The claims operations department maintains timely routing and adjudication of all claims to comply with regulatory guidelines. 

Video Call


Credentialing verification is performed for each IPA contracted physician and mid level healthcare professional.

Call Center

A separate call center is available for members and providers where calls are routinely monitored and logged for quality management.

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