Standard customer reports are provided to clients covering utilization data. Custom reporting is available for clients with specific information needs. Reporting Our MIS can create reports to meet specific client needs and can provide financial information to assist in business management decisions. Provider or client-specific reports are generated at the request of our providers and clients. For example, providers receive a quarterly practice profile comparing them to the rest of the panel and a monthly line-item explanation of payment.
Clients also receive electronic reporting of encounter data.
Panel profiling and utilization summaries are just a few examples of possible reports. A formal complaint procedure is readily available to patients, providers, and payers to resolve any problem with the network's activity or a provider's function. The grievance process is clearly stated in the Provider Operations Manual. Each complaint is fully documented and steps to resolution are taken promptly. Each provider's office is supplied a copy of Member Rights and Responsibilities in English, Spanish and Russian.