Claims

Optima Medical Management Group fully complies with CMS, DMHC and health plan claims payment requirements. We have also consistently scored in the top percentile on claims audits. We consistently exceed the standards of health plan audits. Our strong audit procedures and pre-check run reviews ensure the accuracy of payments before any checks are mailed out.

  • We Process all claims received from providers according to CMS guidelines
  • Allows for electronic submission of claims.
  • Audits claims processing for accuracy consistently using a random sample.
  • Maintains telephonic customer service support with Multilingual representatives.
  • Prepares checks and pays within the time frame provided by contract or by law.
  • Staffs take part in all health plan audits.
  • Configures system for contract and benefit loads.
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We Are Helping Clients Improve Their Medical management Process

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Collaboration

Through technology close communication with physicians, patients and other health care providers

Professionalism

Achieve the highest standards of professionalism through ethical behavior, collaboration, and respect for all

Advocacy

Assist patients with navigating the healthcare system

Integrity

Truthful, equitable and committed to intellectual honesty

Outreach

Patients receive their needed services in a timely fashion

Beneficent

Health program that delivers better patient outcomes in cost effective manner

“Optima offers a fantastic service! It is so easy to use and the customer support is the best around class for management services. Highly recommend them.”

ANDRE MENDOZA

OPERATIONS

“Optima offers a fantastic service! It is so easy to use and the customer support is the best around class for management services. Highly recommend them.”

JOHN BRIANS

PROCESSING

“Optima offers a fantastic service! It is so easy to use and the customer support is the best around class for management services. Highly recommend them.”

ALISA MADISON

CLAIMS

“Optima offers a fantastic service! It is so easy to use and the customer support is the best around class for management services. Highly recommend them.”

MICHAEL GILBERTSON

CLIENT RELATIONS

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Our Services

Optima Medical Management Group, Inc. (OMMG) provides operational, business development, administrative and technical healthcare management services to large physician organizations and health plans. Check out our wide range of services.

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OMMG’s clients included approximately 1000+ physicians and 350,000 patients in Independent Physician Association (IPA). OMMG processes more than $10 million annually in healthcare claims and other medical reimbursements. OMMG’s clients are located throughout California.

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