Quality Assurance

We provide systematic monitoring and evaluation to facilitate oversight of countless healthcare/public health projects, contracts, and services to help ensure quality. Staff knowledge is aided by extensive experience, training and a corporate emphasis on our quality management system.

Qsource’s first work was as a peer review organization, and providing quality assurance for Medicare beneficiaries, and Medicaid and CHIP members. We assessed compliance with documentation requirements, provided policy reviews and independent medical reviews to determine if services meet professionally recognized standards of healthcare quality, are medically necessary and are delivered in the most appropriate, cost-effective manner.

Medicaid Quality Review

Qsource conducts quality reviews to assist in oversight of Medicaid providers and managed care organizations, assuring confidence that their services meet requirements and providing technical assistance for improvement. Learn more about the external quality review, case review, retrospective and prior authorization review, and program evaluation and contract management work Qsource does for the Tennessee Medicaid program.