Skip to main content

Quality

The ‘Ohana CCS Quality Improvement (QI) Program monitors and evaluates the quality, appropriateness, accessibility and availability of health care services.

Adverse Events

Providers are required to notify CCS via the Adverse Event Immediate Notification form This PDF document will open in a new window.. Notification must be given within 24 hours of the time you're made aware of an incident.

HEDIS®

HEDIS® is a mandatory process that occurs annually. We've developed a toolkit to help identify required preventive services.

HEDIS Toolkit

Description coming soon.

Helpful Information

Clinical Coverage Guidelines
Evidence-based guidelines detailing the medical necessity of procedures or technologies. 

Clinical Practice Guidelines
CPGs outline medical standards of care and best practices.

Medical Records

QI may conduct annual medical record audits in physician offices. Patient records are reviewed for evidence that care and screenings have been documented. Complete information is available in the provider manual.

Provider Participation

Network providers are contractually required to cooperate with quality improvement activities. Providers are also invited to volunteer for the QI Program. Please contact us if you’re interested in volunteering.
  • View Clinical Guidelines

    Clinical Coverage Guidelines
    Evidence-based guidelines detailing the medical necessity of procedures or technologies. 

    Clinical Practice Guidelines
    CPGs outline medical standards of care and best practices.

  • Medical Records

    Medical Records

    QI may conduct annual medical record audits in physician offices. Patient records are reviewed for evidence that care and screenings have been documented. Complete information is available in the provider manual.
  • Provider Participation

    Provider Participation

    Network providers are contractually required to cooperate with quality improvement activities. Providers are also invited to volunteer for the QI Program. Please contact us if you’re interested in volunteering.
contact-us

Need help? We're here for you.

Contact Us
Last Updated On: 9/12/2015