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The PMG Quality Assurance Program is your assurance of a job well done. From our Superior Customer© support service to our periodic physician peer review, every facet of the PMG operation is governed by written policies and procedures, measured against standards of performance, and overseen by both internal and external quality assurance boards. Here are some of the things we do. |
If you want good results, you need a good plan. That's why PMG starts each client's managed care project with a Plan of Operations that:
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Outlines the goals and objectives of the program; |
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Identifies the various tools and oversight programs to be used; and |
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Assigns specific responsibilities for carrying out the Plan. |
Based on these strategic directives, PMG then creates or adopts Policies & Procedures (P&P) specific to the Plan. The P&P breaks down each function and provides detailed guidance for the execution of every task. The Plan and its P&P are reviewed and updated as necessary by the Quality Assurance Committee and submitted to the program's Governing Body.
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| The Policies & Procedures (P&P) that underlie each PMG Plan of
Operations are client-specific, closely-held,
and significant in their size and scope. Every
task and oversight function is addressed.
Measurement standards and standards of performance
are adopted for all qualifying events. Virtually
every activity from patient encounter to outcome reporting
is codified and assigned so that every participant knows what
they're expected to do, when, and how.The P&P are living documents,
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overseen by the Quality Assurance Committee, that change and morph with the needs of the organization and the goals and objectives of the Plan. To ensure their use, participating members of the Plan, such as adjusters, case managers, medical care coordinators and management personnel, are provided with direct on-line access to the complete P&P through the restricted access portal located on this web site.
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Peer review is the organized, systematic review of the care rendered by a specific doctor to a specific patient.
The review is conducted by another doctor of equal training and qualification in the specialty of the doctor being
reviewed. Most of the time, networks and plans utilize peer review only when something bad happens and they need a
formal, objective opinion from a trusted source. At PMG, we don't wait for bad things to happen before we conduct our reviews.
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Each year, we use peer reviews of our top-encounter physicians to find out how good things are going and how we might collectively improve. We call them "benign peer reviews" and, as you can guess, our doctors love them. Each reviewed physician receives valuable feedback that is used to reinforce good practices and highlight areas of exceptional performance. When occasional problems do arise, the issues are discussed physician-to-physician in a helpful, constructive manner.
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In addition to our annual peer reviews,
PMG conducts regular reviews of the documentation our
physicians create when they encounter one of our patients.
Formally called, Medical Record Reviews, these mini-inspections
are conducted by Registered Nurses or other trained personnel who
look at specific patient records to see if they are legible, accurate
and complete. Each review is accomplished in accordance with an industry- standard checklist so that both PMG and the affected
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physician can objectively assess the contents of a record.
The medical record reviews are conducted as a service to both our clients and our physicians as part of our overall quality assurance program. As with the peer reviews, we don't wait for a problem to crop up before we start looking at documentation.
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Putting a face - and a place - to a name is helpful in any business. But, in the medical business, it's especially important to know exactly what kind of environment your patients will encounter when they go to the doctor. That's why PMG conducts site visits for all of our main primary care providers and most of our high-encounter specialists. Each visit is scheduled in advance to ensure that there is no inconvenience to the practice. As with our other reviews, the site visit is conducted in accordance with a detailed industry-standard checklist that is completed by either an R.N. or a trained PMG staff member. |
Being on-site also offers excellent training opportunities for the office staff, and that, of course, is exactly what we do. PMG has developed formal training presentations that cover many aspects of managed care law, quality assurance, documentation, OSHA compliance, and other topics of vital interest to practice staff members.
The vast majority of physicians are quite proud of their offices and staff and look forward to the
opportunity to show others how well they are doing. We look forward to these visits and the opportunities
they bring to forge even closer ties with our network physician service partners.
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