QUALITY ASSURANCE

HealthSmart continually monitors our providers to ensure they offer members the highest standard of care they deserve. In cases where the standard of care is in question, an unbiased Quality Assurance Committee makes the determination if the matter is of a serious or minor nature, and whether or not it can be corrected. Once the Quality Assurance Committee makes a recommendation, our Credentialing Committee implements the recommendation while following credentialing policies and standards regarding provider participation. The Quality Assurance Committee ensures that professional standards are maintained among providers at all times. This process also enables us to minimize provider billing problems and monitor programs for professional standards of care. Our knowledgeable Quality Assurance Committee is comprised of clinical staff and network and operations management.

Through our Quality Assurance Committee and continual reporting, we are able to provide consistent high-quality care for our clients and their members.