NY Manual
SHP Manual

SHP Provider Manual
6.3 Compliments | 7.1 Quality Assurance, Performance Improvement (QAPI) Plan and Compliance

6.4 Quality Review and Oversight

   •   Records of grievances, appeals and compliments are stored, tracked and reviewed by the Vice President of Clinical Excellence or designee.

   •   Providers may be asked to investigate individual or aggregate grievances and may be asked to define action improvement plans, as necessary.

   •   Results of activities are reported to the Quality Utilization and Management (QUM) Committee to determine ongoing issues, trends and opportunities for improvement. Recommendations may also be made to limit a provider’s participation in the network.

   •   The results of the review and analysis are also reported to the Quality Management Committee.