Medical Record Reviews/Site Visits
Medical Record Reviews
In accordance with Federal and State laws and regulations and standards set forth by the National Committee for Quality Assurance (NCQA), PrimeWest Health maintains provider standards and guidelines for documentation and management of PrimeWest Health members' medical/treatment records. Provider groups under contract with PrimeWest Health are required to have medical record keeping practices in place that comply with PrimeWest Health's standards and guidelines regarding confidentiality, availability, system of medical record organization, and methods to assess the quality of medical record keeping as described in the PrimeWest Health Medical Records Policy and Procedure.
Site Visits
In accordance with contracts between PrimeWest Health and the Minnesota Department of Human Services (DHS) and standards set forth by the National Committee for Quality Assurance (NCQA), PrimeWest Health provides site visit guidelines for the offices of all credentialed practitioners.
Effective January 9, 2011, PrimeWest Health will no longer conduct initial or follow-up clinic site visits on a regularly scheduled basis. NCQA standards were updated and changed in 2009 to require site visits when the health plan receives member complaints identifying quality, safety, or accessibility concerns. PrimeWest Health conducts ongoing monitoring and investigates member complaints related to quality for all credentialed practitioners, taking into account the severity of an issue based on reasonable thresholds for the number of reported complaints. If the complaint threshold is met for complaints related to quality and safety, accessibility, physical appearance, and adequacy of waiting and examining room space, PrimeWest Health will conduct a site visit. See the Provider Office Site Visits Policy and Procedure for more information.
2007 Medical/Treatment Record Audit Report
2007 Provider Site Visit Report
2008 Behavioral Health Treatment Record Audit Report
2008 Medical Record Audit Report
2008 Provider Site Visit Report
2009 Behavioral Health Treatment Record Audit Report
2009 Medical Record Audit Report
2009 Provider Site Visit Report
2010 Behavioral Health Treatment Record Audit Report
2010 Medical Record Review Report
2010 Provider Site Visit Report