Site Visits/Medical Records Audit

The Quality Improvement Department performs annual office site visits to all Ambulatory care delivery sites in support of our MCO delegated contracts and as a part of NCQA accreditation. The Quality Department representative will use the office site tool that is approved by all the MCOs to audit clinics and facilities. NCQA and TDI standards require that all PCP offices (Family Practice and General Internal Medicine), OB/GYN and all Behavioral Health sites receive a medical record keeping audit. The medical record keeping audit scores will be used during initial credentialing of PCP's, OB/GYNs, and Behavioral Health practitioners and for recredentialing of PCP's and Behavioral Health practitioners.

The Quality Department also performs medical records documentation audits on practitioners from all specialty group practices. Patient satisfaction survey data, information from the Provider Relations Department, and MCO practitioner information are used to decide which practitioners will receive a medical records documentation audit. Audit scores are mailed to practitioners using inter-office mail. Quarterly summaries of all site visits and audit results are forwarded to the MCO's.