Southern California Physicians Managed Care Services offers a full range of management, administrative and financial services designed to assist physician groups in meeting and exceeding their growth and profitability goals. Clients may choose the full suite of services or they may select the individual services that best meet their needs.
Capitation, Accounting and Financial ReportingTrained and experienced financial personnel manage all aspects of clients' financial needs, from accounting to financial analysis and customized reporting. Services include:
Claims Payment and EncountersExperienced analysts review claims according to standard processing guidelines and in concert with each client's specific needs and direction. Fully delegated by the contracted Health Plans for claims payment. Services include:
Client ServicesTrained client services representatives are readily available to assist with operational issues and answer procedural questions. Services include:
Eligibility and BenefitsDedicated eligibility staff review electronic downloads and custom reports to assure accurate and timely eligibility information. Services include:
Health Plan ContractingExperienced contracting team reviews, analyzes and negotiates full risk and shared risk health plan contracts for all products. Services include:
Information TechnologyOur Information Technology Department supports SCPMCS operations with essential tools and services including advanced computer systems, telephones, fax and copy equipment. We maintain 99.9 % uptime record for our major systems. Services include:
Management ReportingSCPMCS advanced systems enable the delivery of comprehensive standard reporting packages, as well as the development of customized reports for clients. Standard reports include:
Medical ManagementOur Medical Management system features physician directed, client specific referral and authorization processing resulting in excellent review and timely responses to the physician. We provide proactive review and management of individual inpatient and outpatient members needs. Services include:
Network Development and Provider ContractingExperienced contracting professionals are available to develop a provider panel that meets the needs of each client's programs. Services include:
Network Management and Provider RelationsService is our only business and our dedicated representatives work with our clients and their physicians to maintain open communications and deliver smooth operations. Services include:
Provider CredentialingSCPMCS offers an efficient, timely, in-house, multi-level credentialing process from initial credentialing through site visits and the recredentialing cycle. Services include:
Quality ManagementSCPMCS provides focused quality management and analysis using multiple methods of oversight and studies to assure compliance and continuous quality improvement. Services include:
Web Site HostingSCPMCS provides a web-based application for exchanging information between physicians and the MSO. Available 24 hours a day, 7 days a week, reducing faxing, voicemail, and telephone calls. Our application features strict security and encryption technology. Services include:
HITRUST CertifiedSCPMCS has achieved HITRUST Risk-based, 2-year (r2) Certification on our EZCap suite of managed care systems. HITRUST Risk-based, 2-year (r2) Certified status demonstrates that the organization’s EZCap suite of managed care systems has met key regulations and industry-defined requirements and is appropriately managing risk.
This achievement places Southern California Physicians Managed Care Services (SCPMCS) in an elite group of organizations worldwide that have earned this certification. By including federal and state regulations, standards, and frameworks, and incorporating a risk-based approach, the HITRUST Assurance Program helps organizations address security and data protection challenges through a comprehensive and flexible framework of prescriptive and scalable security controls
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Senior Management TeamOur team of dedicated, experienced professionals supports our clients in meeting their long-range business goals while helping them manage day-to-day operations.
Chief Executive Officer
Chief Financial Officer
Director, Medical Management
Director, Network Management