Health Plans
UCLA Health Medicare Advantage Plan
Members: 1-833-627-8252
Providers: Contact for details
More DetailsHealthcare Management Services At Its Best
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 10,000 physicians throughout Los Angeles, Orange and San Diego Counties.
Our mission is to uphold the highest ethical standards in the delivery of medical care within a managed care environment. We are committed to placing the health, dignity, and well-being of every patient at the center of all decisions. Through integrity, transparency, and evidence-based practice, we strive to balance quality care with responsible resource management. We foster collaboration among patients, providers, and payers to ensure equitable access, informed choice, and continuity of care. Our goal is to preserve the physician’s professional autonomy and moral responsibility while promoting accountability, compassion, and respect in every aspect of clinical and administrative practice.
S&S Management, Inc. offers various options for processing 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 Claims Department ensures all claims received are processed and paid correctly according to regulatory requirements. S&S Management, 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 experienced in 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.
Participating providers are able to access member eligibility information through the Provider Portal. Eligibility is updated on a daily, weekly or monthly basis based on the time/frequency the information is received from health plans.
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, and lower costs.
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.
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.
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.
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.
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.
At Advantage Care, we are committed to using the latest medical advances and technologies to deliver the best possible care to our patients. We believe that our patients deserve access to the most advanced treatments and procedures available.
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Members: 1-833-627-8252
Providers: Contact for details
More DetailsIf you need assistance or would like more information, please contact us at the following:
Phone: (626) 943-7465
Monday - Friday: 9am - 5pm
Fax: (626) 458-8051
Email: info@sandsmanagement.com
Address:
S&S Management, Inc.
1020 S. Garfield Ave.
Alhambra, CA 91801
Compliance Hotline (anonymous): 626.387.3111
Compliance Mailbox: 4compliance@sandsmanagement.com
