ConfigurationThe Configuration Department practice of handling changes systematically so the system maintains its integrity over time. They also provide technical and administrative direction and implementation of the procedures, functions, services, tools, process, and resources.
They further ensure regular housekeeping of the Configuration System data, produce reports and management information, including impact analysis reports and configuration status reports and identify opportunity and submit proposals for improvement with respect to tools, staff, training, process, procedures and work instructions. Information TechnologyThe IT Department is responsible for providing the infrastructure and application for automation needed by other departments. They are committed to high standards of excellence for protection of the company's assets and information technology resources and implement sufficient controls and security measures to protect confidentiality, integrity and accuracy of information, prevent disruption of operations and ensure proper accountability.
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ClaimsThe Claims Department regularly establishes clearly defined goals and standards to improve the effectiveness of our claims processing. This group is responsible for timely and proper payment of all claims under CMS / DHCS regulations.
ComplianceThe Compliance Department is responsible for performing continuous monitoring and auditing of Health Plans, as well as adhering to all regulatory requirements and guidelines set forth by CMS. Health Source MSO also has an onsite monitoring team to assist in improving their claims-payment processing, policies and procedures, and reporting requirements mandated by CMS.
EligibilityThe Eligibility Department updates patient’s eligibility and information from the health plans and ensures member updates and reconciliation. This is to allow providers and other authorized users to look up real-time member eligibility information via a secured portal.
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Health Source MSO