S&S Management, Inc. has been managing medical groups and independent practice associations for over 25 years.Through the use of advanced technology, leveraging of best practices and dedication to customer satisfaction, we take pride in meeting the business needs of our clients to ensure the delivery of quality, affordable healthcare.
Established in 1995 to provide business operations support to Stewart Medical Group, S&S Management Inc. developed a reputation for its stellar customer service, strong relationships with health plan partners, and ability to drive results. After being approached by physician organizations for our expertise and access to a full range of management services, S&S Management, Inc. clients include over 10000 physicians throughout Los Angeles, Orange and San Diego Counties.
S&S Management, Inc. strives to provide exceptional healthcare management services tailored to meet the needs of each Independent Physician Association and Medical Group we support so that together, we can deliver cost effective, high quality care and better outcomes to have a positive impact on the members we serve.
S&S Management, Inc. offers various options for processes monthly capitation payments for primary care and specialty providers. Capitation detail reports to support calculations accompany each payment. Membership and capitation payment information is also available on-demand for providers to access through our Provider Portal.
The S&S Management, Inc. Case Management team is comprised of RNs, LVNs and other support staff. We work closely with members, caregivers, physicians and health plans to create and manage treatment plans, coordinate healthcare services and connect members to resources available to keep them healthy and in the community.
The Claims Department ensures all claims are received are processed and paid correctly according to regulatory requirements. S&S Managment, Inc. encourages electronic claims submission from providers directly through the Provider Portal and Office Ally.
S&S Management, Inc. has a team of professionals who are knowledgeable in various reimbursement methodologies and experience negotiating managed care contracts with payors and providers. They are able to resolve escalated issues, build networks as well as support physicians through education and training.
S&S Management, Inc. handles all credentialing and recredentialing of providers for its clients according to NCQA requirements. Upon verification of all credentialing information, providers are presented to the Credentialing Committee on a monthly basis, and as needed, to review and approve files. S&S Management, Inc. provides ongoing monitoring of practitioner sanctions, complaints and quality issues.
Participating providers are able to access member eligibility information through the Provider Portal. Eligibility is updated on a daily, weekly or monthly based on the time/frequency the information is received from health plans. Prior to posting eligibility data into the Provider Portal, S&S Management, Inc. reconciles the information to ensures its accuracy.
In addition to preparing and submitting financial reports to meet regulatory and health plan requirements, S&S Management, Inc. provides its clients with various reports which include key metrics to monitor and track performance, identify opportunities
for revenue, improve quality of care, lower costs and to help drive strategic decisions.
Robust audit processes are in place to ensure data integrity. Reconciliations are regularly performed on all incoming revenue and outgoing payments.
S&S Management, Inc. has a team of HEDIS and Risk Adjustment Specialists who work closely with providers year-round on risk adjustment coding and HEDIS initiatives. The team facilitates completion of annual well visits, leads interventions, conducts chart reviews and administers provider incentives to promote quality health care services.
S&S Management, Inc. has a Quality Management Program to evaluate, monitor and ensure that all members are able to access quality health care services and receive stellar customer service. S&S Management continuously reviews and monitors data such as, but not limited to, complaints, grievances, sentinel events, claims, authorizations to identify opportunities for improvement.
The Utilization Management team is comprised of clinical staff, including Medical Directors and physician reviewers. As service requests are received, the team applies clinical guidelines to ensure the delivery of quality health care services to members
in the most appropriate setting.
The Provider Portal is available for participating providers to submit service requests. The system allows providers to submit supporting medical notes and other information needed for clinical review.
Technology is critical to effective and efficient healthcare management services. S&S Management, Inc. uses MSO Exec, a web-based proprietary system, for core functions such as claims, eligibility, authorizations, etc. A Provider Portal is available for participating providers. Portal access and training is available for new providers and as requested.
There are knowledgeable customer service representatives available to assist members, providers and other callers during business hours. Callers may be routed to different departments for further assistance, if needed. Messages received are responded to within 24-28 hours of receipt.
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OUR ADDRESSIf you need assistance or would like more information, please contact us at the following:
(626) 943-7465, Monday - Friday: 9am - 5pm
S&S Management, Inc. 1032 S. Garfield Ave. Alhambra, CA 91801
Compliance Hotline (anonymous): 1-855-662-SAFE
Compliance Reporting Website (anonymous): www.safehotline.com/SubmitReport, Company ID: 4237443530,
Compliance Mailbox: email@example.com