Finance & Reporting

The Finance Department is responsible for the preparation of the Internal Financial Function for our contracted clients

The Finance Department tests the profitability of each of the health plan’s contract, its products, risk pools and assists the outside independent accounting firm in complying with federal and state regulatory requirements.

Reportings

  • Generate financial statements and budgets, and perform analysis for the following:
    • Capitation
    • Contracts
    • Profit/loss by line of business
  • Model new compensation and incentive models based upon IPA criteria
  • Manage each IPA bank account and reconcile bank statements
  • Maintain financial controls
  • Audit and reconcile all health plan revenue collections, including risk pools
  • Perform A/P functions
  • Manage relational database of benchmarks and historical experience to ensure the quality and integrity of the data
  • Develop ad-hoc reports on a prior approval basis

Physician Capitation Management & Eligibility

  • Audit capitation reports and reconcile eligibility files
  • Create and maintain capitation system tables
  • Administer current capitation methodology, recommend available options
  • Optima MMG recognizes the need for accurate and timely data to effectively work within an increasingly complex health care reimbursement system, driven by new products, federal and state mandates, consumer demands, risk adjustors and quality performance indicators.
Let’s Talk

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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