Frequently Asked Questions

A management services organization provides the administrative and operational infrastructure a physician group needs to run in managed care — functions like utilization management, credentialing, claims, contracting, and compliance — under a delegation agreement. MSO, Inc. provides these services to IPAs and medical groups operating under health plan contracts across California, Texas, and Arizona.

Many MSOs are practice-management or PE-backed entities that provide billing, HR, and back-office support to individual physician practices, often tied to ownership arrangements. MSO, Inc. is a managed care MSO: it runs the delegated functions IPAs and medical groups need to operate under health plan contracts — utilization management, credentialing, claims, capitation, and compliance — focused on operational management rather than practice ownership.

Delegation is when a health plan authorizes an IPA, or an MSO on its behalf, to perform functions the plan is responsible for — such as utilization management or credentialing — under the plan's oversight. MSO maintains the policies, documentation, and audit-readiness to operate as a delegated entity.

Delegated credentialing is a formal arrangement in which a health plan authorizes an IPA or MSO to credential providers on its behalf, under the plan's oversight. It speeds provider onboarding and gives the group more control over its data, but requires NCQA-aligned policies, a credentialing committee, and audit-ready documentation — all of which MSO maintains for its clients.

Any combination of core managed care functions — utilization management, credentialing, claims and encounter data, contracting, financial reporting, compliance, risk adjustment, member services, and provider network operations. Clients choose which functions MSO retains and provides.

Yes. MSO adjudicates, processes, and pays claims on CMS timelines, and keeps encounter data submissions accurate and penalty-free.

Yes — through provider coding education, chart review coordination, RADS submission, and HCC/RAF gap identification from claims data.

Yes. MSO provides IPA formation and development consulting, including organizational structure, contract negotiation support, credentialing setup, and operational readiness.

Yes. MSO builds its programs to NCQA standards and maintains compliance with CMS, DMHC, DHCS, and health plan delegation requirements.

MSO consistently achieves top audit scores across credentialing, claims, network operations, and information systems on behalf of its managed IPAs.

Founder and CEO Lan Phan, who has more than 40 years in California managed care and previously built MD Care Health Plan to 17,000 Medicare members before its sale to Humana.

Contact MSO to scope which functions you want to delegate. Reach the team at (818) 399-8996 or lanphan@msosocal.com.