Quality

We are committed to giving you high standards of quality We focus on improvement in care and services. We review our Quality Management (QM) program every year to find opportunities for improvement You can also help us understand where we need to improve the way we do things. Your satisfaction with us as your health plan is our goal. Some things we do for our members are:

  • Education of prevention and wellness care through calls and other outreach for:
    • Well visits and dental visit
    • Lead screening
    • Women’s health screenings like mammograms and cervical cancer screenings
    • Pregnancy care
    • Surveying members and providers to measure satisfaction (CAHPS survey)
    • Working with members who have serious health issues through case management
    • Giving members information on the website about what health care costs
    • Looking at how long it takes for a member to get an appointment
    • Monitoring phone calls to make sure your call is answered as quickly as possible and that you get correct information
    • Working with your Primary Care Physician (PCP) or provider to get them all the information to provide you or your child the care you need
    • Reviewing calls and complaints from members
    • Reviewing all aspects of the health plan through committees that include health plan staff, medical providers, and members

This list includes just some of our quality programs. Call Member Services toll-free at 1-855-463-0933 (TTY/TDD: 711) to find out more. You can always call us if you need help finding a doctor.