Quality Measures

As we identify Quality Measures, we may work with federal, state, or commercial health insurances to track specific measure requirements. Our Quality Measure Report was developed so that insurances can gauge how well their members are being cared for.

The premise behind achieving quality metrics is simple. Delivering high quality care and services is rewarded and is a major focus for federal and state insurance programs. One example is the goal of primary care providers increasing preventative care for patients. This is shown to decrease the excessive number of in-office visits, hospital admissions and readmissions, as the patient begins to experience more positive health outcomes.

At QPI, our Quality Measures Director and team works with providers to identify and close gaps in care, based on patient demographic, diagnosis and applicable quality measures per visit, to improve overall health outcomes. By closing care gaps, healthcare providers are incentivized by insurances. QPI is dedicated to reduce Medical Record Audit requests from recurring due to habitual open care gaps or unsatisfied quality measures. Additionally, QPI identifies claims that are not coded to the highest specificity per HCC (Hierarchal Condition Category) based on patient diagnosis, and works with providers to close these gaps effectively.

QPI collects reportable measures by utilizing HARP Light Technology. Our system of weights and measures include:

Quality Outcome Measures

Reputation Management Tracking

Medical and Patient Record Audits

A large risk that providers identify with pertain to medical records/ patient records. Incomplete or inaccurate medical records/ patient records can put a healthcare organization at risk. For a multitude of infractions, these risks can lead to allegations of fraud, abuse or malpractice.

Our services include conducting third-party medical and patient record audits that comply with federal, state, local and payer laws, regulations and standards. QPI’s Risk Management Team is established to audit a random sampling of 25% or a complete 100% of a healthcare organization’s medical/ patient records. Adverse and incomplete findings are communicated immediately with your organization for intervention.

Not only will our medical/ patient record audits identify and protect against fraudulent claims or billing activity, they will also serve as a guide to identify opportunities for additional credentialing, contract renegotiations, open care gaps and areas of improvement for patient flow.

QPI Healthcare Services™

Quality Outcome Measures

Reputation Management Tracking

Medical and Patient Record Audits

Medical Record Audits

Patient Record Audits

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