Provider Information and Resources

Nivano Physicians helps health care providers and physician partners improve patient outcomes with information and support.

We use good customer service, modern health technology, and a clear vision to reach this goal. We also meet national provider identifier requirements and health insurance portability standards.

Our partnerships with physicians and health plans are supported by our effective health services. These services improve plan performance and provider satisfaction. This includes claims administration, utilization management, and provider portal access for all Nivano members and participating practitioners.

Administrative Services and Provider Support Functions

We support health care providers with streamlined processes that improve practice management and patient care outcomes. These services include direct authorization and claims submission through our secure provider portal. We meet CMS requirements and national provider identifier protocols.

For quick help with any administrative function, contact our customer service team for assistance.

Key administrative services include:

Streamlined claims administration with fast processing
Direct authorization and claims submission through secure portals
Utilization management and peer review services
Quality management programs that meet health maintenance organization standards
Professional contracting and credentialing services
Provider Portal with real-time access to member information
Credentialing that meets CMS and state requirements

Why Choose Us?

Experience the Nivano Difference in Healthcare

At Nivano Physicians, we focus on what healthcare professionals need. We offer direct help, current technology, and simple paperwork. This helps you focus on your patients.

You get quick access to member eligibility and claims processing. You also get helpful customer service and credentialing support. Our provider services are made to be simple and save you time.

We work closely with health plans and government agencies. We meet all Medicare, Medicaid, and health maintenance organization standards.

With Nivano Physicians, you get a trusted partner focused on your success.

Highly-Qualified Professionals

Board-certified physicians committed to exceptional patient care.

Top-of-the-line Equipment

Advanced medical technology for accurate diagnosis and treatment.

Fast and affordable services

Efficient scheduling with competitive pricing and quality care.

Satisfaction Guaranteed

High patient satisfaction through personalized, responsive service.

Provider Resources and Health Plan Information

Get provider information and resources from major health plans and organizations that serve our Sacramento providers.

These include bulletins, guidelines, and updates from Medicare, Medicaid, and health maintenance organizations.

Our system gives you access to all documentation for best patient care and claims processing.

Essential Government, Regulatory, and Health Plan Provider Resources

Government and Regulatory Resources:

Medi-cal Bulletins – Current Medicaid program updates and provider notices
Access To Care Standards – DMHC compliance requirements for health care providers

Health Insurance Plan Resources:

Anthem Medicare Provider Toolkit – Medicare Advantage plan information and provider guidelines
Aetna Bulletins – Health insurance updates and policy changes

For questions about any health plan resource or provider information, contact our dedicated support line for assistance.

Your Trusted Healthcare Partner in Sacramento

Our provider portal gives you access to member information, claims processing, and utilization management tools for healthcare providers. The portal works with national provider identifier systems and maintains HIPAA compliance for protected health information.

You can access real-time eligibility verification, submit prior authorizations, and manage patient care coordination through our secure, easy-to-use interface.

Features include secure messaging with our customer service team, downloadable provider bulletins, and direct access to Apollo Managed Care for managed care resources. The system supports both inpatient and outpatient care management, with tools for ambulatory care providers and utilization reviews.

For technical support or help with portal access, contact our customer service department for assistance.

Don't Miss Your Medicare Enrollment Deadline!

Explore Medicare Advantage plans that include Nivano Physicians—an Independent Physician Association with 400+ primary care physicians, 1,200+ specialists, and 89 urgent care centers across Northern California.

Annual Enrollment Period ends Dec. 7th.

Or Call (916) 407-2000 ext. 2512

Quality Management and Utilization Review Services

Nivano Physicians offers quality management programs that help health care providers deliver good patient outcomes while meeting health maintenance organization standards and CMS requirements. Our utilization management services include peer review processes, ambulatory care coordination, and programs for both inpatient and outpatient services.

Our quality programs focus on evidence-based care protocols, provider education, and ongoing improvements that benefit both physicians and their patients. We work with health insurance plans to ensure smooth care coordination and appropriate utilization of healthcare services, including pharmacy benefits management and ambulance service coordination when needed.

Contact our team for quality management support and assistance.

How Can We Help

Your Partner in Practice Support and Administrative Excellence

Nivano Physicians serves as your partner in healthcare delivery, providing provider information and administrative support that lets you focus on patient care. Our team understands the challenges of working with multiple health insurance plans, Medicare and Medicaid requirements, and the importance of keeping accurate national provider identifier information. We make administrative processes easier, provide quick customer service, and ensure compliance with all health insurance portability and accountability act requirements.

Whether you need help with claims administration, utilization management, or access to the latest provider bulletins and resources, our Sacramento-based team is ready to support your practice.

Contact us to learn how our provider information services can improve your practice efficiency and patient care outcomes.

Empowering Providers with Trusted Healthcare Solutions Across California

Nivano Physicians is a healthcare organization serving health care providers in the Sacramento region and across California. We provide administrative services, provider information resources, and technology solutions that support physician practices in delivering quality patient care. We work with health insurance plans, Medicare and Medicaid programs, and health maintenance organizations to help with care coordination and claims processing.

We focus on customer service and update our provider information systems and support services to meet healthcare needs. We maintain current provider resources, ensure regulatory compliance, and support quality patient outcomes for physicians throughout California.

Partner with California’s Premier Healthcare Administration Team

Experience the Nivano Physicians difference — where healthcare administration meets genuine patient advocacy, and your well-being always comes first.

Take the first step toward better health today with your FREE Annual Wellness Physical — no copay, no cost, just proactive care built around you.

Professional Organizations and Quality Resources

Stay informed with resources from leading healthcare professional organizations and quality assurance bodies that provide essential guidance for health care providers. These organizations offer evidence-based guidelines, continuing education opportunities, and quality measurement tools that support excellent patient care and provider development.

Quality Standards, Professional Organizations, and Clinical Resources

Quality and Professional Organizations:

National Committee for Quality Assurance – Healthcare quality measurement and improvement resources
Bridges to Excellence (BTE) – Quality-based provider recognition programs
National Quality Forum (NQF) – Healthcare quality standards and measures

Medical Professional Associations:

American Diabetes Association (ADA) – Diabetes care guidelines and provider resources
American Board of Internal Medicine (ABIM) – Board certification and continuing education
American Academy of Family Physicians (AAFP) – Family medicine resources and clinical guidelines

These professional resources complement our provider information services and support your commitment to quality patient care. For assistance accessing any professional organization resources, contact our customer service team.

Technology and Health Information Systems

Use health information technology resources that support healthcare delivery and meet health insurance portability and accountability act requirements. Our partners provide certified tools for electronic health records, prescription management, and secure health information exchange.

Health Information Technology Resources:

The Certificate Commission for Health Information Technology (CCHIT) – Health IT certification and standards
Express Script/NextRx – Prescription management and pharmacy services

Our provider portal works with these tools to give you access to patient information, utilization management tools, and claims processing systems. All tools keep your information private and support the secure exchange of protected health information between health care providers and health insurance plans.

For technical support or information about using these systems with your practice, contact our technology support team for assistance.

Nivano Physicians Patient Testimonials

We’re honored to support the patients and families who rely on our physician network every day. Here’s what a few have shared about their experience with Nivano Physicians.

Help When I Needed It Most

“When I needed a specialist for my diabetes, Nivano made sure I got referred quickly and everything was handled. I felt like I had someone looking out for me the whole time.”

Rosa M.

Fast, Friendly, and Always There

“I’ve called their team a few times to help with insurance questions, and every time they’ve been so helpful and kind. It’s rare to get this level of service anywhere else.”

Kevin D.

They Made Everything Simple

“I was overwhelmed trying to understand my Medicare plan, but the team at Nivano guided me step by step. They helped my doctor get the authorizations needed and kept me informed.”

Carmen L.

Say Hello

Claims Administration and Billing Support

Make your practice’s money matters easier with our claims administration and billing support services. Our team helps with claims submission and appeals processing. We work with health insurance plans, Medicare, and Medicaid programs. We make sure your national provider identifier is used correctly. We follow all CMS requirements for good claims processing.

Our claims administration services include fast processing for urgent requests. You can submit directly through our provider portal. We give full support for both inpatient and outpatient services. We work with all major health maintenance organizations and health insurance plans. This means you get paid on time with fewer claim denials.

Our billing support team knows how modern healthcare payment works. We help you improve your practice’s revenue cycle. Contact our team for claims administration support or billing questions.

GOT QUESTIONS?

Check Out Our FAQs

How do I access the Nivano provider portal and what information is available?

The Nivano provider portal gives you secure access to member eligibility verification, claims submission, prior authorization requests, and utilization management tools. Health care providers can access current patient information, download provider bulletins, and contact our customer service team. Contact our provider services team to access the portal or get login information.

The portal maintains full HIPAA compliance and protects all protected health information according to health insurance portability and accountability act requirements.

What health insurance plans does Nivano work with and how do I verify coverage?

Nivano Physicians works with major health insurance plans including Medicare, Medicaid, and health maintenance organizations in the Sacramento region. Our provider portal offers real-time eligibility verification for all participating health plans. You can also verify coverage by contacting our customer service team.

We have current contracts with many insurance providers to provide full coverage for your patients.

How does the claims administration process work and what support is available?

Our claims administration process includes electronic submission through the provider portal, expedited processing for urgent requests, and appeals support. Claims are processed according to CMS guidelines and health insurance plan requirements, with automatic compliance checking for national provider identifier and other required fields. Our claims department provides support for complex cases and is available to assist with any claims-related questions.

What utilization management services does Nivano provide?

Nivano offers utilization management services including prior authorization processing, peer review coordination, and care management for both inpatient and outpatient services. Our utilization management team works with health care providers to make sure care is appropriate while meeting health maintenance organization requirements and quality standards. Services include ambulatory care coordination, specialty referral management, and pharmacy benefits oversight. For utilization management support, contact our clinical team for assistance.

How do I stay updated on provider bulletins and regulatory changes?

Provider bulletins and regulatory updates are available on our provider portal, email notifications, and links to resources from government agencies and health insurance plans. We send regular updates on Medicare and Medicaid policy changes, health maintenance organization requirements, and CMS guidelines. Our customer service team also sends updates on changes that may affect your practice. To make sure you get all provider information updates, contact our team to verify your contact information.