Review contracting
Gain insight into typical PPO terms and understand the competitiveness of your contracting.
Partner with MedScore360 to drive optimal results
We have the inside story on provider performance in managed care networks. For 25-years, we have been contracting with doctors in various specialties to participate in PPO and MCO engagements.
Our team has run both managed care networks and physician groups. We have seen the interaction of PPO contracts, medical billing, and patient outcomes.
We want to help you succeed, and we want to partner with you to improve patient access to care and payor access to better medical groups.
Elevate your practice performance boost your business
Improve networks access
Develop policies and processes to maximize your performance in quality-based networks.
Measure and analyze
Optimize best practices and benchmark billing and collections to improve your business.
Frequently asked questions
How do I join one or more of your MPNs?
Not all programs are available in every area. If there are gaps in geography or specialties, we are happy to consider your group for inclusion. To start, please click the "Connect with Our Team" button above and fill out the contact information.
What are the important metrics to be considered a top doctor in the MPN?
When evaluating physician performance, we consider several factors. Medical outcomes include the speed of recovery, adherence to guidelines, and successful resolution of care without the need for additional or corrective procedures. We also take claim outcomes into account, such as the quality of report writing, the patient's return to work, and the accurate identification and documentation of permanent and stationary status.
What experience do you have in Medical Group operations?
The founder of MedScore360 established and operated two large occupational medical groups in California, which encompassed 43 clinics across the state. In these clinics, we implemented various cost-saving measures, performance improvement strategies, and billing and collections processes that contributed to making our group the fastest-growing occupational medicine provider in California. We aim to share this experience with you to help build better medical groups in the California marketplace.
What advice do you have for doctors in your programs?
When we were in your position, we drew from our background in the managed care industry before operating medical clinics. To become a valuable partner for our large employers and carriers, focus on the areas you can control that will have the most significant impact on their challenges. Strive to minimize wait times, manage disability cases effectively, and work with us to facilitate quicker access to specialists and ancillary services. Additionally, please let us know if you feel that a patient’s care is not progressing as it should.
In what specialties do you offer consulting?
We provide consulting to Urgent Care clinics looking to improve their workers' compensation business, Occ Med clinics looking to optimize their performance and presence with large employers, and specialists like Orthopedics, Hand, and Neurosurgery looking to expand their reach into workers' compensation patient referrals.
