Quality Management

The Quality Management Department coordinates quality of care, and quality of service issues for our contracted clients with their contracted Health Plans. Our clients committed oversees the functions of the Utilization Management, Risk Management, and ongoing provider and member health education. Our trained team takes an active part in the oversight of site reviews and ensuring our clients and their contracted provider network maintain compliance. The QM Department strives to meet all NCQA, STATE, DHS,CMS and HEDIS guidelines in monitoring the quality of services of our provider to the members. Quality Management includes the following:

  • Quality Management Committee Meetings
  • Clinical Practice Guidelines
  • Grievance And Appeals Process
  • Provider Satisfaction Surveys
  • Member Satisfaction Surveys
  • Access Studies
  • Coordination Of Quality Management Issues Between Departments
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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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