Transcription of Data collected during audit 1: Date: Data collected …
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Data collected during audit 1: Date: Data collected …
*Indicates non-scored item for 2013 audit year. Updated 1/13 A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 1 HMOs of Blue Cross Blue Shield of Illinois 2013 Utilization Management Adherence audit I. Utilization Management Committee Activity IPA # Nurse Liaison: Data collected during audit 1: Date: _____ Data collected during audit 2: Date: _____ Member survey by IPA score for referral question: _____ <85 REQUIRES INTERVENTION PCP survey score for PCP referral question: _____ <85 REQUIRES INTERVENTION May 2013 Jun 2013 Jul 2013 Aug 2013 Sept 2013 MONTHLY REQUIREMENTS (10) (1 pt for each meeting) Chair/members present listed AND Members present match with list in IPA UM Plan (5 ) # Physicians at meeting (TOTAL): (10) # Specialists at meeting (1 OR >).
*Indicates non-scored item for 2013 audit year. Updated 1/13 2 Discussion of 6 month summary of avoidable days, reasons for delayed discharge, and any IPA physician
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