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  • ADVANTAGE CARE IPA
  • ADVANCED MEDICAL DOCTORS OF CALIFORNIA, INC.
  • AMERICAN WEST HEALTHCARE SOLUTIONS
  • DOCTOR'S MANAGED IPA, INC.
  • HEALTHCARE ASSOCIATES OF CALIFORNIA, INC.
  • PARAMOUNT IPA
  • STEWART MEDICAL GROUP
  • VITRUVIAN CARE IPA
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To consider a request for an Appeal, you must complete a Waiver of Liability Statement, holding the enrollee harmless regardless of the outcome of the appeal. A Waiver of Liability Statement can be found at https://www.cms.gov/medicare/appeals-and-grievances/mmcag/downloads/model-waiver-of-liability_feb2019v508.zip ; once we receive the completed Waiver of Liability form, we will give you a decision on your appeal within 60 calendar days

Or

Click here for the Waiver of Liability (WOL) statement form.

MSO Exec is only compatible with the Google Chrome browser. If you do not have the Google Chrome browser, please click in the following link: https://www.google.com/chrome/

If you are a contracted provider, and need access to this portal, please contact us at (626) 943-7465 or via email at info@sandsmanagement.com

If you are interested in becoming a contracted provider, please fax your letter of interest, curriculum vitae, NPI and W-9 to our Contracting Department at (626) 658-2832 or via email at credentials@sandsmanagement.com

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