What Monida Healthcare Network does

Monida Healthcare Network is a not-for-profit Physician Hospital Organization (PHO) founded in 1996 and headquartered in Missoula, Montana. It functions as a regional association governed by its member physicians and hospitals, pooling administrative resources on behalf of 900+ providers, 7 hospitals, and ancillary healthcare facilities across Montana and Idaho, with select services extended across the broader Western United States and Alaska. Its core service lines are provider credentialing to NCQA standards, third-party payer contracting under a messenger-model PHO structure, external peer review for hospitals, healthcare professional staffing, revenue cycle management and medical coding (Monida Healthcare Billing Solutions), group purchasing, access to MICA malpractice insurance at group rates, and member education programming.

The organization operates through a member-governed PHO structure that generates recurring membership subscription revenue and supplements it with fee-based managed services sold to both members and non-members. Service delivery combines in-house teams with affiliated entities: wholly-owned subsidiary Monida Healthcare Staffing Solutions (founded 2007), the Big Sky Credentialing Credentials Verification Organization, and the Monida Shared Imaging, LLC joint venture (formed February 2007 with three rural hospitals, radiologist Dr. Breck Howard, and BP Consulting) which operates a mobile MRI scanner serving 13+ rural facilities across Montana and Wyoming. A 501c3 affiliate, Monida Healthcare Network Resources, provides access to grant funding for rural behavioral health and community health initiatives. Underlying technology is a healthcare administrative platform supporting credentialing, billing, claims resolution, and practice management, deployed against NCQA credentialing standards and MGMA benchmarking for revenue cycle work. HIPAA Business Associate Agreements are available for members and clients; no APIs, SDKs, mobile applications, or AI/ML capabilities are disclosed.

Commercially, Monida pursues a sales-led, direct outreach motion targeting physicians, mid-level providers, allied health professionals, hospitals, surgery centers, and home health agencies in its core Montana-Idaho geography. Distribution is supported by content marketing via the 'Reform in 5 Minutes!' blog, a monthly Learn at Lunch educational series, partnership-driven clinical simulation training with Montana Health Network, and direct member communications. The peer review program is the most geographically extended line, reaching 60+ hospitals across the Western US and Alaska, while the core PHO membership remains concentrated in the Northern Rockies region.

Name

Monida Healthcare Network

Legal name

Monida Healthcare Network

Website

https://monida.com

Company type

Private

Founded year

1996

Operating status

Operating

Headcount range

1–10 employees

Short description

Monida Healthcare Network is a not-for-profit Physician Hospital Organization founded in 1996 that pools administrative resources for 900+ providers and 7 hospitals in Montana and Idaho, offering credentialing, payer contracting, billing/RCM, staffing, external peer review, group purchasing, malpractice insurance access, and a mobile MRI joint venture.

Ownership category

akta.pro rank

Product category

Healthcare Administrative Services (Physician Hospital Organization)

NAICS

Ambulatory Health Care Services (621)

SIC

Services-Health Services (8000)

akta.pro primary industry

Hospital Shared Services, GPOs & System Support Organizations (HLAFAAAO)

Keywords

• Healthcare administrative services
• Physician hospital organization
• Medical credentialing services
• Revenue cycle management
• Healthcare staffing solutions

Headquarters

HQ city

Missoula

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Membership Fees: Annual membership fees from healthcare providers (physicians, mid-levels, allied health professionals) and facilities (hospitals, surgery centers, home health agencies) who join the PHO network to access bundled services including credentialing, payer contracting, malpractice insurance discounts, group purchasing, and peer review
2. Billing and Coding Services: Fee-based revenue cycle management services including charge entry, claims processing, denial management, CPT/HCPCS/ICD coding, reimbursement posting, and accounts receivable management for practices and facilities
3. Staffing Solutions: Recruitment and placement of healthcare professionals (RNs, LPNs, CNAs, MAs, allied health, clinical lab and office personnel) providing travel, per diem, emergent and permanent positions
4. Managed Services: Fee-based services including payroll, bookkeeping, IT consulting, practice management, workflow processes, customer service training, and credentialing for non-members
5. Malpractice Insurance: Group rate malpractice insurance through MICA (Mutual Insurance Company of Arizona), offering members significant discounts off posted rates
6. Group Purchasing: Volume discounts on office/medical supplies, cell phones, health insurance, coding books, answering services, and advertising through group purchasing programs

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels5 records

Core offering

Monida Healthcare Network is a not-for-profit Physician Hospital Organization (PHO) that provides healthcare administrative services to its member physicians, hospitals, and ancillary providers across Montana and Idaho. The core offerings include NCQA-standard provider credentialing, external peer review, healthcare professional staffing and recruitment, medical billing and coding (revenue cycle management), payer contracting, group purchasing programs, malpractice insurance access through MICA, and a mobile MRI joint venture service traveling to rural facilities.

Product overview

Monida Healthcare Network is a Physician Hospital Organization (PHO) offering a comprehensive suite of healthcare professional services organized around a core network model. The portfolio includes Credentialing Services (NCQA-standard primary source verification), Peer Review Services (external quality review for hospitals), Staffing Solutions (recruitment and placement of healthcare professionals), Billing Solutions (revenue cycle management and medical coding), Shared Imaging (mobile MRI joint venture), Payer Contracting (contract management for members), Education Services (Learn at Lunch series and workshops), Group Purchasing Programs (volume discounts on supplies and services), Malpractice Insurance (MICA group rates), Managed Services (payroll, IT, practice management), and Big Sky Credentialing (credentials verification organization). The network serves over 900 providers and 7 hospitals across Montana and Idaho, formed in 1996 as a not-for-profit association.

Differentiator

Problem solved

Functional benefit

Products and services

• Credentialing Services Provider credentialing services according to NCQA standards, including primary source verification of education, licensing, malpractice insurance coverage, and board certification, with delegated credentialing to payers. Monida handles initial credentialing and monitors re-credentialing for all network payers, reducing administrative burden on members.
• Peer Review Services External peer review services for hospitals to monitor medical staff performance and identify quality improvement areas, performed by licensed board-certified physicians. The program serves 60 hospitals across the Western United States and Alaska.
• Staffing Solutions Healthcare professional recruitment and placement services providing RNs, LPNs, CNAs, Rad Techs, MAs, allied health, clinical lab, and medical office personnel for travel, per diem, emergent, and permanent positions, primarily serving rural healthcare settings in Montana and Idaho.
• Billing Solutions Revenue cycle management services including charge entry, claims processing, denial management, medical coding (CPT, HCPCS, ICD-10), reimbursement posting, accounts receivable management, and compliance support. The team includes AAPC Certified Coders and Billers.
• Shared Imaging (Mobile MRI) Joint venture mobile MRI service traveling across Western Montana (and Wyoming) to serve rural facilities and patients who would otherwise have to travel to Missoula or surrounding communities for an MRI, distributing the high capital cost of MRI equipment across multiple hospitals.
• Payer Contracting Third-party payer contract management as a messenger model Physician Hospital Organization, providing direct contracts with payers and dedicated staff for working on claims issues on behalf of members. The service includes contract management and reimbursement support.
• Education Services Monthly Learn at Lunch series and workshops covering healthcare topics relevant to medical practice, with partnerships for on-site clinical education and patient simulation courses addressing broad clinical and operational educational needs for members and their staff.
• Group Purchasing Programs Volume discount programs for office and medical supplies, cell phones, health insurance, coding resources, answering services, and radio/television advertising, leveraging the network's pooled purchasing power for member benefits.
• Malpractice Insurance (MICA) Access to medical malpractice insurance from Mutual Insurance Company of Arizona (MICA), an A-rated malpractice carrier, at group discount rates off posted prices for member physicians and healthcare providers.
• Managed Services Fee-based business services including payroll, bookkeeping, IT consulting, customer service training, and practice management for healthcare practices, with initial assessments to determine service needs. Available to both members (at discounted rates) and non-members.

Named customers7 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

Six partnerships are on record, tiered core and moderate.

• BP ConsultingcoreStrategic or Co-development Partner · 1 January 2007BP Consulting operates mobile MRI scanners across the western United States and provides daily operational support for Monida Shared Imaging joint venture. The partnership enables rural hospitals affiliated through Monida to share the cost of mobile MRI equipment without each facility having to cover the full capital cost of approximately $1 million+ for a first-class MRI scanner.
• Breck Howard, MDcoreStrategic or Co-development PartnerDr. Breck Howard, a radiologist for St. Luke Community Hospital, is a partner in the Monida Shared Imaging joint venture along with BP Consulting and Monida. His clinical expertise supports the quality of MRI readings and interpretation for the mobile service.
• MICA (Mutual Insurance Company of Arizona)coreOthersMonida Healthcare Network offers members access to MICA malpractice insurance at significant discounts off posted rates. MICA is an A-rated malpractice carrier providing professional liability coverage for physicians and healthcare providers in the network.
• Montana Health NetworkmoderateOthersMontana Health Network provides on-site clinical education addressing a broad range of educational needs for Monida members. They offer patient simulation in many courses, allowing clinical staff to learn new techniques and refresh skills. This partnership enhances Monida's educational offerings beyond the monthly Learn at Lunch series.
• Big Sky CredentialingmoderateOthersBig Sky Credentialing is a Credentials Verification Organization (CVO) that offers full provider credentialing and payer enrollment services. They partner with Monida to provide additional credentialing support, completing all applications and necessary follow-up to achieve successful credentialing for providers.
• 501c3 Monida Healthcare Network ResourcesmoderateOthersMonida Healthcare Network Resources is a 501c3 affiliated organization that enables the network to apply for grants that assist in delivering better care, improving health outcomes, increasing accessibility and availability of behavioral health services in rural areas, and establishing specialty outreach services.

Scale indicators6 records

Recent moves8 records

Expansion highlights6 records

Direct peers

• Caravan Health: Caravan Health partners with rural and community health systems to form ACOs and provides population health, analytics, and administrative support — directly comparable to Monida's PHO model of pooling rural providers to gain contracting leverage and reduce administrative burden.
• Aledade: Aledade partners with independent primary care physicians to form ACOs, providing technology, analytics, and payer contracting support. Comparable to Monida's network model aggregating independent providers for shared services and contracting leverage.
• Agilon Health: Agilon Health partners with primary care physicians to take on full risk arrangements with Medicare Advantage plans. Comparable to Monida as a network model organizing independent providers for payer contracting and care delivery support.
• Privia Health: Privia Health is a physician network and medical group platform offering practice management, payer contracting, and value-based care enablement. Comparable as a multi-state provider enablement platform bundling administrative services for independent providers.

Emerging players

• VillageMD: VillageMD is a value-based primary care platform providing practice management, technology, and clinical support to physician offices. Comparable to Monida in supporting independent practices with operations and contracting, though focused on primary care and urban/suburban markets.
• Sound Physicians: Sound Physicians provides hospital-based physician services and external peer review across the US. Comparable to Monida's external peer review line of business serving 60+ hospitals, though with a much broader service scope and geographic footprint.
• Health Management Associates: HMA is a consulting and research firm focused on healthcare delivery, especially for safety-net and rural providers. Comparable to Monida in its focus on rural/community healthcare operations, though focused on advisory rather than direct service delivery.

Broad incumbents

• Optum (UnitedHealth Group): Optum operates one of the largest healthcare administrative services and care delivery platforms in the US, providing RCM, credentialing, analytics, and care management. Comparable as a broad incumbent offering many of the same administrative services Monida offers but at vastly larger scale.
• Evolent Health: Evolent Health provides value-based care, specialty care management, and administrative services to health plans and providers at national scale. Comparable to Monida's administrative services and payer contracting functions but at a much larger, multi-state scale.
• Centauri Health Solutions: Centauri provides risk adjustment, quality improvement, and revenue cycle services to health plans and providers. Comparable to Monida's billing/coding and quality/peer review service lines but operating at national scale across payers and providers.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles6 records

Subsidiaries3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Monida Healthcare Network