Quality Assurance

Qsource is experienced in rapidly initiating quality assurance and program evaluation projects while ensuring accuracy in reporting. We provide systematic monitoring and evaluation to facilitate oversight of healthcare and public health projects, contracts, and services to help ensure quality.

Qsource provides independent quality, policy and medical record reviews to determine if services meet requirements and professionally recognized healthcare standards, are medically necessary, and delivered in the most appropriate, cost-effective manner. We also offer technical assistance for sustainable improvement. Skilled in contractual and regulatory compliance, Medicaid and Medicare technical assistance, billing reconciliation and utilization, our staff has extensive experience and training aided by a corporate emphasis on quality.

Our work in Quality Assurance includes assisting with Medicaid and CHIP managed care oversight as an external quality review organization (EQRO), improving emergency care for Medicare patients with review and analyses as a Trauma Quality Improvement Organization (QIO), and advancing quality for Medicare ESRD Networks.

In our atom Alliance work with Medicare providers, we assist nursing homes with the patient-focused Quality Assurance Performance Improvement (QAPI) program. QAPI takes a systematic, comprehensive, and data-driven approach to maintaining and improving safety and quality in nursing homes while involving all caregivers in practical and creative problem solving.

Qsource has maintained a 100% customer satisfaction rating for EQRO during our decade of work in Tennessee. We have also leveraged our expertise to assist TennCare with reporting rates for a core set of Medicaid adult and child healthcare measures.

Learn more about our experience in external quality, case, retrospective and prior authorization reviews, and in program evaluation and contract management work: