QUALITY ASSURANCE TECHNIQUES – Class 5

Quality Assurance Techniques Include:

  • Grievance procedures
  • Satisfaction surveys
  • Advisory committees
  • Scrutinizing utilization & outcome data
  • Credentialing Physicians
  • Peer Review
  • Education and/or suspension from plan is recommended when there is recurrent evidence of suboptimal care

Techniques to assure enrollees quality and customer satisfaction include grievance procedures, satisfaction surveys, advisory committees, and scrutinizing utilization and outcome data. Physicians are carefully screened before being credentialed. Their care is under periodic physician peer review. Education and/or suspension from the plan is recommended when there is recurrent evidence of suboptimal care.