With a panel of over 3,000 physicians, 50 Medical Groups/ IPAs, 69 Hospitals and a myriad of Ancillary providers, PNO builds and manages Care1st provider network throughout Los Angeles county. With state-of-the-art information system with on-line Internet accessibility and highly experienced management support to achieve optimal provider satisfaction.

PNO understands the importance of developing and maintaining solid relationships with providers and the barriers that the under served population must overcome in order to access health care services. As a mixed model HMO, Care1st contracts with individual physicians and Medical Groups/IPAs on a capitated basis. Under the Medical Group/IPA arrangements, many operational functions are delegated with Care1st providing oversight.

Working closely with You
Our mixed model also offers an opportunity for independent physicians and other provider types to contract directly with Care1st under flexible reimbursement methodologies. It is our desire to be the most provider responsive department by working closely with our providers to better understand the obstacles facing them in order to improve the delivery of health care services.

Access to Care Standards
Care1st uses these guidelines to make sure that its members have access to care.

Accessibility to Care and Services
Key findings, goals, interventions, analysis, and progress study.

Member Satisfaction Survey Results (CAHPS®)
The Consumer Assessment of Healthcare Providers and Systems (CAHPS) program is a public-private initiative to develop standardized surveys of patients' experiences with ambulatory and facility-level care.

Quality Study Results (HEDIS®)
These are studies done every year, measuring the ability of the health plan to provide services to members.

Medicare 2008 QI program Description
Providing an effective, system-wide, measurable plan for monitoring, evaluating and improving the quality of care and services.

Medi-Cal 2008 QI program Description
Providing an effective, system-wide, measurable plan for monitoring, evaluating and improving the quality of care and services.

Procedures & Guidelines We release up-to-date information for providers, on state mandated procedures via manuals & newsletters.

	•	Provider Newsletter - Spring 2008
	•	Provider Newsletter - Winter 2007
	•	Provider Newsletter - Spring 2007
	•	Provider Newsletter - Fall 2007
	•	HIPAA Alert
	•	Provider Manual
	•	The Providers' Guide to Detect & Report Fraud
	•	Quality Improvement Incentive Program
	•	Provider Dispute Resolution Request Form

Medical Record Documentation Standards
Care1st’s goal is to assure each patient has a legible, detailed, well organized, confidentially stored, easily retrievable medical record. These records need to be consistent with standard medical and professional practice and meet the standards of oversight organizations, including Care1st Health Plan and regulatory agencies.

Care1st Health Plan recommends a six section format