Quality Plan

Service Authorization PrimePointers Claims Submission Dental Maternal/Child Health Home & Community Based Services (HCBS) Hospital Behavioral Health Mental Health Targeted Case Management
(MH-TCM) Chemical Dependency Long-Term Care/SNF Personal Care Assistance (PCA) Health Care Directives

Case Management Disease Management/ Chronic Care Improvement Program (DM/CCIP)

Service Authorization

Formularies Formulary Exception Process

HEDIS Performance Improvement Projects (PIPs) Appeals & Grievances Practice Guidelines Quality Plan Public Reports Medical Record Reviews/Site Visits