About Us

History

Managed care arrived in the South Bay in the mid-1980s. As its popularity grew in the South Bay, Torrance Memorial Medical Center and its medical staff recognized the need for an organization that would permit physicians in private practice to care for patients with HMO insurance. The Torrance Hospital Independent Practice Association Medical Group (THIPA) was formed in 1985. Since then, THIPA has grown to include 157 primary care physicians and 258 specialty physicians. You also have access to acupuncture, chiropractic care, optometry, podiatry, and physical therapy when offered by your health plan. 57,000 individuals in the South Bay have selected THIPA to be their health care provider. THIPA has commercial contracts with Aetna, Blue Cross, Blue Shield, CIGNA, Health Net, Great West, and PacifiCare. Our senior Health Plans are Aetna Golden Medicare, Blue Cross Senior Secure, Blue Shield 65 Plus, Care 1st Health Net Seniority Plus, MD Care, and Secure Horizons.

Philosophy

THIPA physicians retain control of their own practices. Our physicians formed an Independent Practice Association (IPA) to ensure that the quality of the care and service its member physicians provide meets THIPA's high standard. THIPA is constantly developing and refining clinical programs to promote integration of care and best practices among our physicians. THIPA also has a dedicated team of physicians who specialize in managing patients in the hospital. These hospitalists are available seven days a week, 24 hours per day. They make sure that your primary care physician knows about your hospital care.

Why should you choose THIPA as your health care provider group?

1. THIPA is not a large medical group with a service area that spans all of Los Angeles County. THIPA serves only the South Bay. We believe that because our focus is local, we can offer you more personal service and the most efficient use of medical resources.
2. Torrance Memorial Medical Center, our affiliated hospital, is one of the largest and most respected hospitals in the area.
3. THIPA has been consistently rated the highest ranking IPA in the South Bay.
4. THIPA physicians are conveniently located throughout the South Bay. You will find a doctor in a location convenient for you.
5. THIPA's referral process to specialists is fast and hassle-free.
6. THIPA is a financially sound, physician-owned organization. We have 19 years of experience serving the South Bay.
7. THIPA has the lowest administrative expense of any IPA in Southern California. Our low overhead ensures that we devote the maximum of our financial resources to your care.
8. THIPA has many physicians who have an exclusive affiliation with our organization. Some examples include cardiology, gastroenterology, orthopedic surgery, ophthalmology, and urology.

THIPA Referrals Policies

THIPA prides itself on its referral process. Most of our referrals are "Direct." This means that your primary care provider can make a referral to many of our specialists and no review is necessary. You can often leave the PCP office with the referral and an appointment to the specialist.

Our Utilization Management department only reviews requests that require benefit verification or requests for medical treatments for which the health plans have specific policies.

THIPA's utilization decision-making is based only on well-documented and accepted medical criteria and the medical appropriateness of care and services. No provider or any other individual, including the medical director or the utilization management staff, conducting utilization review receive any financial incentive for issuing denials of coverage or service. THIPA has no financial incentives that would encourage under-utilization of medical services. Criteria used in making a referral decision can be requested by contacting our Member Services department.

Our Utilization Management department only reviews requests that require benefit verification or requests for medical treatments for which the health plans have specific policies.

THIPA's utilization decision-making is based only on well-documented and accepted medical criteria and the medical appropriateness of care and services. No provider or any other individual, including the medical director or the utilization management staff, conducting utilization review receive any financial incentive for issuing denials of coverage or service. THIPA has no financial incentives that would encourage under-utilization of medical services. Criteria used in making a referral decision can be requested by contacting our Member Services department.

THIPA Self Referrals benefits

THIPA is affiliated with the following Health Plans:

Commercial Plans: Aetna, Blue Cross, Blue Shield, CIGNA, Health Net, Great West, and PacifiCare.

Senior Plans: Aetna, Blue Cross, Blue Shield, Care 1st , Health Net, MD Care, and Secure Horizons.

As long as you have a commercial (HMO) or senior plan from any of these insurances, and are a member of THIPA, you can receive the THIPA Self-Referral Benefit.

With THIPA’s Self-Referral Benefit, you don’t need an authorization and you may call to make an appointment with one of THIPA’s providers in the following specialties: Cardiology, Dermatology, Gastoenterology, OB & Gynecology, Orthopedic Surgery, Podiatry, Pulmonology, Rheumatology, and Urology. For all other specialties, you will still need to get a referral from your THIPA PCP or specialist. Click here to see a list of participating physicians in our self-referral program. Just pick up the phone and call any of them to make an appointment.

THIPA Self-Referral is a program offered to you in addition to your already existing benefits. It does not change any benefits you already have. Since this benefit is exclusive to THIPA, you may only see specialists within THIPA’s network. However, with over 250 specialists located throughout the South Bay, you are sure to find a doctor who will fit your needs.

This is an exclusive benefit that THIPA provides to both our commercial and our senior members. There are no additional premiums, no additional deductibles, and no additional copayments to use this benefit.

Provider Compensation

The following is a description of the compensation methodologies currently in effect to reimburse our physician/providers for services rendered to our members.

The majority of THIPA's providers are paid fee for service. A small number of providers are reimbursed through capitation. In the fee for service system, the provider is paid a contracted fee for health care services provided to our members. Under capitation, services are covered by a fixed monthly payment usually based on the number of members served.

Any operating surplus accumulated (excess of revenue over expenses) is distributed annually to THIPA physicians. The THIPA Board of Directors determines the distribution method.