To promote excellence in health care through evaluation and education

Health

Cms qin/qio 11th sow which we participate in as a sub to tmf (texas medical foundation) - provided quality control peer review services in acordance with section 1154 of the social security act in accordance with the requirements and deliverables of the 11th scope of work. arkansas medicaid review - provided review services as required by contract:prior authorization of med/surg procedures - 7,565prior authorization of mumps - 23,441prior authorization of dme - 25,784targeted case management review - 36retro emergency room review - 42,179retro inpatient review - 33,575extension of benefit/molecular pathology review - 34,225organ transplant review - 66pvt option reviews - 97nicu - 1,002 medicaid beneficiary relations - a contract to maintain active feedback and professional relations with medicaid beneficiaries. It also includes maintaining a call service center to assist individuals with medicaid and private option coverage. Surveys and monitoring of the non-emergency transportation (net) services are additional deliverables under this contract. Provider relations and connectcare activities were also added to this contract this year. other programs consist of contracts that the organization has with various federal, state, and private agencies.