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As part of
health care management Flora Midwest addresses Quality Assurance in two ways:
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Access to Care and
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Patient/Client Feedback
Access to care is a critical component
in establishing and maintaining the Flora Midwest network. Flora's primary
objective is to assure that the full range of general acute hospital
services are available to participants through contracted facilities in
each service area and that regional services such as burn care are also
included in the network. Analysis of hospital service inventories and
locations are an integral part of the network development process.
Additionally, Flora Midwest uses a unique approach to contracting. We
actively use data from our clients and internal claims data generated from
any in-house re-pricing; to identify highly utilized providers to target
our recruitment efforts. For areas with already established physician
networks, Flora provides customers with an opportunity to nominate
physicians for network participation.
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Patient/Client Satisfaction |
Patient satisfaction is monitored by
documenting and investigating any complaints made to Flora by patients,
brokers, benefit managers, or claims administrators. The role of Flora in
resolving problems and unraveling miscommunications is one of our highly
valued functions as a system intermediary. Any serious quality of care
issues are referred to PPOM's medical director of other appropriate
personnel, for review and consideration regarding any providers continued
participation in the Flora Midwest network.
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