MedPoint Management
MedPoint Management is a California-focused healthcare management services organization that provides backend administrative support — claims processing, credentialing, utilization management, quality management, case management, and call center services — to Independent Practice Associations and healthcare networks.
- Company typePrivate
- Founded1994
- HeadquartersScottsdale, United States
- Headcount101–250
- GTM typeB2B
- OfferingServices
What MedPoint Management does
MedPoint Management is a California-focused healthcare management services organization that has operated for over 32 years providing backend administrative support to Independent Practice Associations (IPAs), contracted healthcare providers, and Health Maintenance Organizations (HMOs). Its service portfolio spans the full administrative stack: claims operations, utilization management, credentialing, quality management (HEDIS/STARs), case management and transition of care, call centers (with Spanish-language and interpretation support), eligibility and benefits, financial management, hospital operations, and provider network operations. The company also employs board-certified physician reviewers available for peer-to-peer utilization review.
Underlying the services is a proprietary-plus-integrated technology stack. EZ-CAP is the core claims processing platform, used with Virtual Examiner, Virtual Reporter, and SymKey modules for manual adjudication, logging, and auditing. The MedPOINT Provider Web Portals handle authorization requests, status lookups, eligibility, and provider training, and are SOC 2 Type 2 compliant and HITRUST e1 certified. Eligibility data flows from contracted health plans on daily to monthly cadences via Eligibility Manager software, and quality measurement runs through the Cozeva HEDIS computation engine (with CozevaConnect EHR integrations) for HEDIS, STARs, RAF/HCC trending, and care gap closure. An internal case management platform houses care plans accessible to approved staff.
MedPoint operates a managed-services business model under B2B contracts with IPAs and healthcare networks throughout California, generating revenue via service fees for administrative functions on behalf of capitated providers. Go-to-market is executed through dedicated field representatives and liaisons who conduct on-site provider office support and onboarding, supplemented by the Quality Point community forum, monthly Provider Quality Newsletters, and a resource library. The company made a 2025 strategic investment in Third Way Health, an AI-enabled healthcare front-office services company, indicating early-stage engagement with AI-native admin-tech. No public revenue or funding data is disclosed.
MedPoint Management firmographics
Firmographics- Name
- MedPoint Management
- Legal name
- MedPOINT Management
- Website
- https://medpointmanagement.com
- Company type
- Private
- Founded year
- 1994
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- MedPoint Management is a California-focused healthcare management services organization that provides backend administrative support — claims processing, credentialing, utilization management, quality management, case management, and call center services — to Independent Practice Associations and healthcare networks.
- Ownership category
- akta.pro rank
MedPoint Management industry classification
Industry- Product category
- Healthcare Administration Services
- NAICS
- Offices of Physicians (62111)
- SIC
- Hospital & Medical Service Plans (6324), Services-Health Services (8000), Services-Prepackaged Software (7372)
- akta.pro primary industry
- Care Management & Population Health Program Administration (HLAEALAG)
- akta.pro secondary industries
- Care Management & Coordination Platforms (case/disease management workflows) (HLACAHAD), Medicare Member Engagement & Care Management (Utilization, Case/Disease Mgmt) (FSAIAGAL)
Keywords
Where MedPoint Management is headquartered
LocationHeadquarters
- HQ city
- Scottsdale
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
MedPoint Management business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales, Others
Revenue model
- IPA Management Services: MedPoint Management provides comprehensive backend administrative services to Independent Practice Associations and healthcare networks throughout California. Revenue is generated through service fees for managing claims operations, credentialing, utilization management, quality management, and other administrative functions for capitated healthcare providers.
Go-to-market motion1 record
Distribution channels1 record
Marketing channels4 records
MedPoint Management product offering
Product offeringCore offering
MedPoint Management provides comprehensive backend administrative management services to Independent Practice Associations (IPAs) and healthcare networks throughout California. Service offerings span claims operations, credentialing, utilization management, quality management (including HEDIS and STARs measurement via the Cozeva engine), case management and transition of care, call center support, eligibility and benefits administration, financial and risk pool management, hospital operations, and provider network operations—delivered through proprietary platforms (EZ-CAP, MedPOINT Provider Web Portals) integrated with third-party systems.
Product overview
MedPOINT Management is a healthcare management services organization providing integrated solutions for Independent Practice Associations and Health Care Networks throughout California. The company operates a platform-plus-services model, combining proprietary technology systems (EZ-CAP claims processing, MedPOINT Provider Web Portals) with comprehensive service offerings including Claims Operations, Utilization Management, Quality Management, Credentialing, Case Management, Call Centers, Eligibility and Benefits, Financial Management, Hospital Operations, and Provider Network Operations. The ecosystem integrates with third-party platforms including Cozeva for HEDIS/STARs quality measurement, Office Ally for claims clearinghouse, and various internal tools for authorization, credentialing, and care management. The company has been serving California healthcare providers for over 32 years.
Differentiator
Problem solved
Functional benefit
Products and services
- EZ-CAP Proprietary claims processing platform with manual adjudication modules (Virtual Examiner, Virtual Reporter, SymKey) used to log, audit, and adjudicate claims for MedPoint's contracted IPAs and healthcare networks.
- MedPOINT Provider Web Portals Web-based provider portal for authorization requests, status lookups, member lists, eligibility information, and provider training access; SOC 2 compliant and HITRUST e1 certified.
- Quality Management Program Comprehensive quality monitoring and evaluation program focused on HEDIS and STAR measure improvement, using the Cozeva HEDIS engine with weekly data ingestion and real-time visibility for contracted IPAs and healthcare networks.
- Credentialing Services Credentialing verification for IPA contracted practitioners, including initial and recredentialing aligned with NCQA 3-year cycle, HDO and sub-delegation services, supported by NCQA Credentialing Accreditation as of August 2025.
- Case Management / Transition of Care RN, LVN, social worker, and allied health staffing providing member support for chronic conditions, medication adherence, care coordination, and DHCS Enhanced Case Management program services.
- Call Centers Three call centers supporting members and providers for utilization management and claims questions, including dedicated Spanish language support and other interpretation services.
- Claims Operations Timely routing and adjudication of all claims with EZ-CAP manual adjudication modules, Virtual Examiner, Virtual Reporter, and SymKey for logging, auditing, and processing claims for contracted IPAs.
- Eligibility and Benefits Daily, weekly, semi-monthly, and monthly eligibility updates from contracted health plans using Eligibility Manager software, with benefit table configuration and co-pay information for accurate authorization and claims adjudication.
- Utilization Management Medical Affairs department covering outpatient/inpatient review and case management, with board-certified physician reviewers and peer-to-peer reviews supporting authorization decisions for contracted IPAs.
- Provider Network Operations Liaison services between contracted IPA providers and HMOs, provider activation, directory reconciliation, onboarding training, and specialty network contracting for access.
- Financial Management Financial team providing accounting, reporting, risk pool reconciliation, forecasting, and data-driven analytics for MedPoint's contracted IPAs and healthcare networks.
- Hospital Operations Risk pool management and continuity of care for capitated members during hospitalization, including hospital claims payment, risk pool reconciliation, and facility network development.
- Quality Point Discussion Board Online discussion forum for network providers, clinicians, and staff to share ideas and discuss best practices for quality measure (HEDIS, STARs, IHA AMP) implementation and reporting.
Quantifiable outcome
- 75% of providers submit claims electronically
- +1 more outcomes
Companies that use MedPoint Management
Customer profileNamed customers1 record
Segments3 records
Ideal customer profiles1 record
MedPoint Management technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration5 records
Feature5 records
MedPoint Management partnerships and signals
Strategic signalPartnerships
Three partnerships are on record, tiered minor and core.
- Third Way HealthminorThird Way Health is an AI-enabled healthcare front-office services company in which MedPoint Management made a strategic investment in 2025. The partnership relates to AI-based healthcare front-office operations.
- Gemini Diversified ServicescoreGemini Diversified Services is a 10-point NCQA accredited Credentialing Verification Organization (CVO) that provides required primary source verifications for MedPoint's credentialing processes.
- CozevacoreCozeva is the HEDIS computation engine used by MedPoint for quality metric tracking, STAR scores, RAF/HCC trending, and care gap closure updates. MedPoint provides CozevaConnect integrations with provider EHR systems.
Scale indicators4 records
Recent moves5 records
Expansion highlights4 records
MedPoint Management competitors and assessment
Company assessmentDirect peers
- Agilon Health: Public value-based care platform partnering with primary care physicians under full-risk capitation, particularly for Medicare Advantage. Comparable in delivering MSO and care management infrastructure to risk-bearing physician groups.
- Heritage Provider Network: Large California-based integrated healthcare organization that operates IPAs and medical groups under capitation contracts with HMOs. Shares MedPoint's California IPA management model and Medicare/Medi-Cal focus.
- P3 Health Partners: Value-based care MSO focused on Medicare Advantage populations, providing care management, network management, and quality programs to physician groups. Comparable in providing MSO services to risk-bearing primary care groups.
- Privia Health Group: Public physician enablement company that provides practice management, MSO, and value-based care services to medical groups across multiple states. Comparable in serving ambulatory physician groups with MSO and population health services.
- Astrana Health: Public California-based IPA management and value-based care platform (formerly Apollo Medical Holdings) that contracts with HMOs and provides care management, UM, and quality programs. Astrana's scale and California focus make it the closest direct comparable to MedPoint's IPA management business.
- Aledade: Large national MSO partnering with independent primary care practices in value-based contracts including Medicare Advantage and ACO REACH. Overlaps with MedPoint in providing population health, quality, and administrative infrastructure to physician groups.
- HealthCare Partners: California-based medical group and IPA management company (now part of Optum) providing care management for HMO and senior populations. Direct comparable in California capitated IPA management.
- Prospect Medical Group: California-based integrated provider network operating IPAs and medical groups under HMO capitation contracts. Directly comparable in California risk-bearing IPA operations and delegated administrative services.
Broad incumbents
- Evolent Health: Public specialty value-based care platform serving health plans and risk-bearing providers, with overlap in care management, UM, and quality performance. Larger, broader portfolio than MedPoint but comparable services for delegated populations.
- Centene Corporation: Large managed care company with significant California Medi-Cal and Medicare presence. Indirect comparable as a payer whose capitation contracts drive demand for IPA MSO services like MedPoint's.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat4 records
Key risks6 records
Key highlights6 records
Customer concentration
MedPoint Management social profiles
Digital presenceMedPoint Management compliance and trust
Trust signalCompliance3 records
MedPoint Management financial estimates
Financial estimateRevenue estimate
Valuation estimate
MedPoint Management leadership team
Management profileNumber of profiles
Profiles2 records
MedPoint Management funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
MedPoint Management M&A and investment
M&A and investmentM&A
Investments1 record
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about MedPoint Management
What does MedPoint Management do?
MedPoint Management provides comprehensive backend administrative management services to Independent Practice Associations (IPAs) and healthcare networks throughout California. Service offerings span claims operations, credentialing, utilization management, quality management (including HEDIS and STARs measurement via the Cozeva engine), case management and transition of care, call center support, eligibility and benefits administration, financial and risk pool management, hospital operations, and provider network operations—delivered through proprietary platforms (EZ-CAP, MedPOINT Provider Web Portals) integrated with third-party systems.
Is MedPoint Management a public or private company?
MedPoint Management is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was MedPoint Management founded?
MedPoint Management was founded in 1994. It employs 101 to 250 people.
Where is MedPoint Management based?
MedPoint Management is headquartered in Scottsdale, United States, in the North America region.
How does MedPoint Management make money?
One revenue line is on record: IPA Management Services.
Who are MedPoint Management's main competitors?
Direct peers on record are Agilon Health, Heritage Provider Network, P3 Health Partners, Privia Health Group, Astrana Health, Aledade, HealthCare Partners and Prospect Medical Group. Broad incumbents are Evolent Health and Centene Corporation.
Does MedPoint Management have an API?
No public API is recorded for MedPoint Management.
What industry is MedPoint Management in?
MedPoint Management's product category is Healthcare Administration Services. Its primary akta.pro industry code is HLAEALAG, Care Management & Population Health Program Administration, with a secondary code of HLACAHAD, Care Management & Coordination Platforms (case/disease management workflows). Its NAICS code is 62111 and its SIC code is 6324.