Introduction to Quality Assurance Essay Example | Topics and Well Written Essays - 750 words - 3

Introduction to Quality Assurance - turn out ExampleIt is also responsible for coordinating and monitoring access to care, developing programs, and evaluating the quality of healthcare serve in accordance with guidelines from the Department of Defense, Lead Agent, Regional 12, and Health Affairs.Specialist Referrals The Primary Care medico (PCP) may request a consultation from a participating specialist physician at all time.The PCP determines the number of visits authorized.Specialists may include Gynecologist, Radiation Oncologists, Ophthalmologists, Pediatric Ophthalmologists, Retinologists and in allergists etc.Emergency Room service An emergency health check condition is defined as a condition that manifests itself by acute symptoms of capable severity (including severe pain) that a prudent layperson with an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in any of the followingOut-of-Plan Referrals A ll out-of-Plan referrals require Plan prior authorization at Guam. These requests are reviewed on an individual basis. Determinations are make based on the patients medical needs and the availability of services to meet these needs within the provider. 3rd Care Services All referrals to plan tertiary care centers are reviewed on an individual basis.The members medical needs and the availability of requested services within the non-tertiary care network are taken into consideration. turn out Planning Patients who require continuing care after release from the hospital are identified and the entrance services are arranged through participating home care, medical equipment and other providers.The facilitys Utilization Management course of instruction may need continued review on a periodical basis in order to keep it on par with the model Utilization Management Program as described by the HealthCare Advisory Council. In keeping with these lines, the program is