Web-based technology for quality care
As part of our ongoing commitment to help you provide the highest quality care to your patients, we’re creating a seamless, web-based program that will outline quality assurance guidelines for procedures that require prior authorization or prior notification. We’ll begin testing the program in late July, and introduce it to the entire network in 2012.
An automated approach to evidence-based care Our new web-based program was created to help us work together to standardize treatment and ensure care quality using evidence-based criteria including:
- Healthcare Effectiveness Data and Information Set (HEDIS) measures
- National quality of care rates as a benchmark for our standard of excellence
- Feedback from physicians in our network
In cases where all quality guidelines are met, you’ll receive automatic approval through this streamlined process.
Program includes preference-sensitive procedures
When testing the new program, we’ll be including several preference-sensitive procedures that don’t currently have prior authorization requirements. (See the list in the April / May 2011 provider newsletter.) These requirements will be expanded to the rest of the network after the testing is completed.
We’ll keep you updated on the status of the web-based technology and any future authorization requirements. If you have any questions, please contact your provider account representative.
Topics: Website news
