Utilization Management

Optima Medical Management Group expedites request for authorizations and coordinates with the Medical Directors the fundamental practice of managed care. We strive to keep referrals within our client’s contracted network. Physician profile referral statistics and hospital bed days reported monthly gives our Clients a current overview of their UM activities.

The Case Manager plays an important role in the monitoring, tracking and implementation of the utilization and quality of patient care process. Optima Medical Management Group enhances the quality and coordination of care to our members. Utilization Managements includes the following:

  • Utilization Management Committee Meetings

  • Inpatient Telephonic Review, Case Management And Discharge Planning Performed By Licensed Nursing Personnel
  • Medical Referrals Processed within CMS guidelines

  • Utilization Management Committee Meetings

  • Inpatient Telephonic Review, Case Management And Discharge Planning Performed By Licensed Nursing Personnel
  • Medical Referrals Processed within CMS guidelines
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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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