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Quality and Performance Management
The purpose of Triad Healthcare's Corporate Quality Management Program is to administer all quality committees, provide a timely and efficient response to Corrective Action Requests, measure and evaluate key indicators relevant to the services of the organization, identify quality improvement opportunities, and ensure the development and maintenance of appropriate policies and procedures.
Triad Healthcare, Inc. is aware that member/client satisfaction is essential to the success of any managed care program. Our Quality Department conducts oversight of all areas, including evaluating clinical quality, network access and quality of service. Our Quality Management program also administers and manages appeals, grievances and concerns of members, providers and client organizations.
The Quality Management program is tasked with the responsibility of measuring and
evaluating:
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The quality of care and service rendered to patients
- The quality of service provided by Triad to our customers
We use the quality standards set by URAC as benchmarks for the policies, procedures and guidelines used in the Quality Management Program and throughout the organization. Governance of the Quality Management Program is the responsibility of the Medical Quality Improvement Committee (MQIC) and the Senior Leadership Team (SLT). MQIC is comprised of practicing pain specialty providers and the SLT is comprised of individuals representing various service areas within the organization to ensure professional diversity and collaboration between areas to achieve common quality objectives.
Benefit Analysis Reporting
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Client experience against normative data
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Fee analysis and comparisons
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Network and provider recruitment analysis
- Network performance and provider profiling
Utilization Analysis and Reporting
Triad Healthcare, Inc. provides sophisticated analysis and reporting to its clients
that identify and explain utilization and cost trends, assess provider quality and
patient outcomes and forecast the impact of our programs on future cost and experience.
Clinical Outcomes Analysis Reporting
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Patient complaint resolution
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Ongoing client specific reporting on Triad Healthcare, Inc. performance using key
clinical and operational indicators
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Continuing care management through data collection analysis
- Ongoing quality improvement evaluations
Surveys
In an effort to build a stronger relationship with providers, members, and clients,
Triad Healthcare, Inc. has developed two surveys to ensure quality and delivery
of care. Surveys are done annually. Additional surveys may be employed during the
year to assess response to shift or changes in the program. These surveys include:
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Provider survey
- Client survey
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