Services

Providing the Services You Need to Succeed

Case Management

Case Management

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Case Management

Case Management

Our professional and friendly case managers will effectively coordinate with patients, their families, and providers to maximize available resources for a quality and cost-effective outcome that meets patients’ health needs. This, in turn, helps your organization achieve its utilization management goals.

Credentialing

Credentialing

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Credentialing

Credentialing

A fast and efficient transaction allows you to work and complete your application at your leisure. Let our Credentialing team, which is fully National Committee for Quality Assurance (NCQA) compliant, assist you with its proprietary physician database that offers a quick turnaround time of 24 hours.

Heath Services

Heath Services

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Heath Services

Heath Services

At NMM, we strive not only to take care of your business but also your members. Our affiliated partners offer a suite of health services, including urgent care, post-acute care, ambulatory surgical centers, and diagnostic laboratories. We encourage all members to take advantage of these resources.

Member Services

Member Services

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Member Services

Member Services

Our Member Services team is available to assist our members with any inquiries related to their health care. We research and resolve authorizations, claims, bills, eligibility inquiries, and transportation needs in a timely manner. For our multi-cultural members and providers, we have bilingual staff available.

Claims

Claims

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Claims

Claims

Fully delegated to process all professional claims, our Claims team adheres to strict regulatory guidelines to ensure timely and accurate payments. We use the latest electronic processing software to digitize claims and eliminate the hassle that paper claims can cause.

Customer Service

Customer Service

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Customer Service

Customer Service

When there are questions, we are prepared to give answers. Our Customer Service team is available to promptly assist our providers with any patient inquiries related to patient care. Furthermore, we can also serve as a liaison between the Primary Care Physician, Specialist, and Member whenever needed.

Information Technology

Information Technology

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Information Technology

Information Technology

Accurate. Efficient. Secure. NMM combines the latest hardware and software to ensure that data gathering and statistical reporting processes meet these three essential guidelines. We also provide training and technical support to all administrative staff and providers who utilize our online applications.

Quality Care and Management

Quality Care and Management

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Quality Care and Management

Quality Care and Management

Our Quality Management Program is designed to promote the highest quality medical care and service to members of NMM and its affiliate IPAs. You can trust our coordination that brings together management and physicians to collaborate on improvement initiatives.

Contracting

Contracting

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Contracting

Contracting

We work closely with our business partners such as health plans, hospitals, laboratories, and ancillary providers to carefully examine key contract elements, such as language, capitation, incentive, and matrix of responsibility, to ensure the maximum benefits for your organization.

Data Management

Data Management

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Data Management

Data Management

It can be hard to keep up in the digital age when data is rapidly being processed and transferred. With NMM handling your electronic data interchange (EDI), data analytics, and web portal operations, you can focus on delivering quality care with peace of mind.

Marketing

Marketing

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Marketing

Marketing

The quest to market your brand is not only time-consuming but also never-ending. That is why we are here to help you. Our Marketing team will assist in developing strategic plans through various media and collaborating with partners in the health care community in accordance with the plans of IPAs and medical groups.

Utilization Management

Utilization Management

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Utilization Management

Utilization Management

In an era where health care costs are skyrocketing, the efficient allocation of resources is paramount. Our Utilization Management team works diligently to ensure that patients not only get the best care over a continuum of time to achieve positive clinical outcomes but also that appropriate utilization for optimal patient care is being followed.