QMetrics has served as both an external validator and survey administrator since the implementation of the Department of Managed Health Care (DMHC) requirements (All Plan Letter dated February 13, 2017 and subsequently updated April 7, 2017).
We have experience in all modes of survey fielding required by DMHC and been an active participant in timely access workgroups and meetings. We strive to work with key stakeholders to fully adhere to the methodology, provide recommendations for improvements to the methodology and tools, and give a voice for our clients’ questions and concerns.
PAAS Administration & Validation
- Reached out to more than 40,000 providers via fax, email, and telephone across single and multi-network health plans with up to 50 counties since MY 2017.
- Dedicated call center partner with live agent interactions to perform all telephonic outbound calls and follow-up.
- Domestically based Call Center
- Our validation staff includes current and former Certified HEDIS® Compliance Auditors (CHCA) with more than 13 years of California health plan and provider group auditing experience.
- Our validation team includes experienced compliance and regulatory affairs managed health care professionals who are well versed in the DMHC methodology and requirements.
- Health plan clients range from small to large and reflect both full and limited Knox- Keene licensures.
- PAAS Software Validation
Provider Satisfaction Survey
The State of California’s Timely Access to Non-Emergency Health Care Services Regulation (§1300.67.2.2, Title 28, California Code of Regulations) requires health plans to maintain an adequate provider network to ensure patients receive timely access to care as appropriate for their condition and to solicit provider’s perspective and satisfaction with the patient’s ability to receive access to care within the timelines set forth under California law.
QMetrics has administered, analyzed, and reported provider satisfaction survey results for our health plan clients. We have more than 20 years of managed care survey research experience including sampling design, questionnaire development, survey administration, as well as insightful analysis and clear reporting of results.
After Hours
The Department of Managed Health Care (DMHC) requires health plans to provide or arrange for the provision, 24 hours per day, 7 days per week, of triage or screening services by telephone. Plans are required to ensure that telephone triage or screening services are provided in a timely manner appropriate for the enrollee’s condition and that telephone medical advice services are available for the plan’s contracted primary care and mental health care provider network.
We have administered the After-Hours Survey using a census or sampling methodology to assess Primary Care and Mental Health provider compliance with the after-hour triage requirements for our health plan clients. We can use a health plan developed survey or customize a survey for you
Telehealth & Customized Surveys
QMetrics has extensive experience in administering surveys and can provide tailored solutions to meet your needs. Survey types include Telehealth for both providers and health plans, client surveys, and employee satisfaction surveys.
Contact us at: info@qmetrics.us for a complimentary consultation.
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