CREDENTIALING

Primary Source Verification of Medical Providers to NCQA Standards and Site Visits of Busy Facilities.    * NCQA (National Committee for Quality Assurance):  independent, non-profit organization that assesses and reports on the quality of care delivered by managed care organizations. Click here to link to NCQA home Page  [..top..]

PRIVILEGING

Optional program that rates the Radiology Sites by the training of the Radiologist(s), Equipment and Service.   [..top..]

FUNCTIONS AS MEDICAL GROUP

Medical Director Licensed in California, Connecticut, Florida, Georgia, New Jersey, New York, Ohio, and Pennsylvania. In California, Medfocus is a medical corporation, complying with the recent California Attorney General opinion letter on the corporate practice of medicine. In New York, being a professional corporation means Medfocus is in compliance with Article 45, which is a requirement to be a legal medical referral network. Professional licensing makes Peer Review and Utilization Management Services more credible.  [..top..]

MEDICAL GROUP WITH ON-SITE, FULL TIME MRI RADIOLOGISTS, ORTHOPEDIST AND NEUROLOGIST AT MEDFOCUS HOME OFFICE

The MRI neuroradiologist and MRI skeletal radiologist are both on the clinical staff of U.C.L.A. Medical School Radiology Department following two year fellowship training programs beyond their residencies. The orthopedist is a Harvard graduate with an Orthopedic fellowship also at Harvard. He has years of experience in managed care and workers' compensation. The neurologist is a clinical professor at U.C.L.A. Medical School and has an advanced degree in neuroelectrophysiology. He wrote some of  the  original research papers on nerve conduction studies.  [..top..]

CENTERS OF EXCELLENCE

Beyond NCQA* Standards of Credentialing and Quality Assurance Programs   * NCQA (National Committee for Quality Assurance):  independent, non-profit organization that assesses and reports on the quality of care delivered by managed care organizations. Click here to link to NCQA home Page  [..top..]

ADMINISTRATIVE STAFF WITH GROUP HEALTH AND WORKERS' COMPENSATION EXPERIENCE

Over 100 combined years of group health and worker's compensation claims experience. The Operations Director is a nurse who has :             A. Extensive claims background             B. Managed the MedFocus orthopedic group             C. Managed the MedFocus national radiology program   The Operations Manager has a Masters in Business Administration (MBA) and a comprehensive background in risk management and human resources.  [..top..]

MED-COORDINATOR - OUR ADVANCED INTERACTIVE SOFTWARE SYSTEM

Tracks the patient from scheduling through study acquisition, billing and reporting.  Utilization of Mapping Software that finds the closest quality site to perform the requested studies. Sends appointment letters to the medical case management nurse, claims examiner, and referring physician; if time permits, a letter is mailed to the patient in English or Spanish. Tracks the radiology reporting to assure reports are received by MedFocus for review and then faxed to medical management nurses within 2-3 days of the scan date. Provides encounter, savings, outcomes and other reporting. Has EDI capabilities for bills, reports, reimbursements and other information.  [..top..]

FLEXIBILITY

Provide customized services and systems to meet client's specific needs.  [..top..]