Innovative Management Systems, Inc

IMS delivers Practice Management and Administrative Services to individual physicians, group practices, FQHCs, and hospitals. IMS focuses on regulatory compliance, customer and provider experience, and measurable quality outcomes. IMS uses enhanced data analytics which enables the practice to regulate and improve overall medical spending, as well as the successful management of HEDIS and STAR measures. Maintaining current technology is critical in the managed care environment. The development of customized and automated reports will result in the ability to build provider protocols which will not only enhance the health care outcome of the member, but will allow our clients to maximize revenue compensation. With the consistent trend of a members financial risk shifting from the health plan to the provider, it is important to have an MSO team that understands the intricate concepts of managed care and is knowledgeable of health plan goals and regulatory requirements. The IMS team was carefully selected for their experience in the industry coming from a wide range of various nationwide health plans, California IPAs, and other MSO’s. This collective experience and expertise enables IMS to thoughtfully establish best practice protocols in an effective multi-payor environment. Since 2021, IMS has quickly become an industry expert and leader in the application for and management of California Restricted Knox-Keene health plans. We have successfully led in the filing of two RKK applications with the California Department of Managed Health Care (achieving an average of only 8 months from initial filing to licensure) and manage those plans in the areas of network development, claims, utilization and case management, credentialing, compliance, and negotiating plan-to-plan contracts with unrestricted Knox-Keene health plans. We have expanded our services and now manage a third RKK health plan and provide DMHC/CMS compliance consulting services to a fourth RKK health plan.