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Who is MSO of Puerto Rico?

MSO of Puerto Rico, LLC (MSO) started in 2007 administering the first contracts to providers and was established on August 1, 2009 as an independent legal corporation to provide services to MMM Healthcare, LLC (MMM) and the whole medical community.

 

MSO of Puerto Rico is an organization that provides administrative support to medical plans and medical groups. It focuses on operational optimization for the benefit of all its customers and the patients they serve in tune with the needs and new trends of the health industry. The organization is known for helping its clients achieve optimal results through innovation. They are facilitators of organizational solutions focused on improving quality metrics through initiatives and collaborative strategies that promote effective care models.

 

They work together with more than 8,000 health care providers to provide the health care that their affiliates need. These providers include hospitals, primary physicians, specialists, medical groups, pharmacies, emergency centers, and an extensive list of supplemental service providers.

  • The mission of MSO is to improve the health and well-being of the people of Puerto Rico through innovation and true change. They achieve this by creating lasting partnerships that deliver excellent results, financially and professionally. The key to success is always ensuring satisfaction through a service mindset aimed at developing and implementing solutions for the benefit of the client and the patients they serve.

     

     

    • Raúl F. Montalvo, M.D. / President
    • Roberto Robledo / Chief Financial Officer
    • Annie Mayol / Chief Administrative Officer
    • Waldemar Ríos, M.D. / Chief Medical Officer
    • Gonzalo Salinas / Chief Clinical Officer
    • Ángel Muntaner, M.D. / Vice President of Network Performance and Innovation

Commitment to Quality of Services and Innovation

 

From the beginning, MSO has focused its efforts to improve health services throughout Puerto Rico. The industry is moving towards a care model based on quality and innovation, and MSO's efforts are geared towards offering it.

 

 

  • This portal is an integrated and effective communication channel between its customers and the network of providers. The portal provides access to up-to-date clinical information more quickly and accurately to support the continuity of beneficiary services. The new version of InnovaMD 2.0 adds more features and includes an increase in the level of security in compliance with federal and state regulations, simplifying the user experience, and ensuring the information and transactions performed on the portal.

     

    Beneficios y Funcionalidades

    • You will have the opportunity to work the various applications in a more fluid and simple way.
    • Includes a section called Practice Center, which will allow you to manage your profile, assign delegates to your office, and other additional services.
    • Consolidates the profile of all beneficiaries and their clinical information to provide greater agility to the medical practice.
    • It allows the search of information with new parameters through improved functions, facilitating the uniform use of the portal.
    • The new version allows you to process multiple transactions for the beneficiaries in your office during the creation, requesting services and reporting encounters.
    • Integrates a model with multiple functions to request referrals and pre-authorizations, and to monitor the quality of the services provided.
    • Provides a new information center that provides regulatory training, clinical guides, educational modules, provider bulletins, communications, and circular letters. Allows you to grant limited access to your office staff as delegates of your assigned roles on the InnovaMD portal.
    • Provides more information to registered users about their roles.
    • It facilitates in an easy and agile way the managing of information between the lines of business.
    • MSO is the only company offering access to the first HIE HUB in Puerto Rico, to obtain important clinical information from patients under strict confidentiality, privacy, and security standards.
    • Provides access to the provider directory, SMART Paper, to validate the eligibility of your patients and to the drug formulary, among others.
  • MSO ensures service satisfaction through the commitment to develop and implement solutions that promote communication and education as the main focus. In this way, they create long-lasting relationships that offer financial and professional rewards.

     

    Some of its tools include:

    • Personalized visits by service representatives
    • A dedicated call center specialized in handling provider issues
    • Tools and reports to facilitate operational and administrative processes
    • Continuing education and training for providers and office staff
  • In order to continuously provide the provider network with alternatives where it is ensured that their data is recorded in an easy and fast way, they coordinated the services of a delegated entity that provides electronic contracting, credentialing and provider document validation.

     

    If you are interested in becoming part of the provider network

    If you are a network provider and want to update your documents

    If you want to know the status of your request or changes

  • Offer claim payment and processing services that are versatile, flexible and accurate. In addition, it complies with the payment time standards established by state and federal entities.

  • As part of the commitment to the health of patients, they offer services dedicated to improving and controlling their health conditions, thus ensuring a continuous and coordinated care among the different health providers of the patient.

     

    Services include:

    • Hospitalization and post-discharge planning to ensure that care resources for patient-to-hospital transition are consistent with the goals set out in the recovery plan.
    • Case Management Group assigned to work with patients with special needs and / or chronic conditions to assist them in controlling these conditions.
    • Health Education team that preventively advises patients on how to keep their health conditions under control and to comply with their preventive tests and vaccines.
  • To guarantee integral wellbeing, it is necessary to attend the mental health and conditions of living of the patients. This is why two dedicated units have been established to meet these needs.

    • Mental Health: Provides a unit dedicated to working in conjunction with the provider network to safely and efficiently evaluate and manage the mental health needs of patients.
    • Social Work: puts at the service of patients a social worker who helps connect all areas to perform a psychosocial evaluation in the patient's home.
  • As part of efforts to support our providers in collecting data in a cost-effective manner, and in turn achieving greater commitment from patients, we have developed different innovative programs. These include:

    • Office Advantage: : A professional development program, especially designed to support medical office staff.
    • Primary Medicine Support Centers (CAMP for its acronym in Spanish): These provide an alternative for the patient to receive health services when an urgency is presented and their primary care physician is not available.

For more information on MSO of Puerto Rico, LLC you can contact:

Provider Services
Phone: 1-866-676-6060
Monday to Friday 7:00 a.m. to 7:00 p.m.

Postal Address
PO BOX 71500
San Juan, P.R. 00936

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