MEDICAL MANAGEMENT 

Features

Case Management: telephone triage / nurse advice system, hospital case management, ambulatory case management, dedicated management of high-risk patient populations

Referral Management: online and fax-based authorization receipt options, UM Committee support for all denied and deferred referral requests, integrated clinical protocols based on each client’s needs, community resource referrals

Criteria

MSO Inc. of Southern California makes the UM Criteria used to make UM decisions available to members and practitioners upon written request.

Hours of Operation

UM staff is available during 8:00 AM – 5:00pm Monday through Friday.

MSO Inc. has a toll free number for members and providers to call 1-800-551-1319 and TDD/TTY: 711.

Language Assistance is available to Members to discuss UM issues. This service is provided free of charge.