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Blue Cross Blue Shield of Michigan (BCBSM) recently completed their annual practice site visits. The Physician Alliance (TPA) had one primary care and one specialty practice selected for visits.
BCBSM randomly conducts practice site audits to confirm the accuracy factor of patient-centered medical home (PCMH) and patient-centered medical home – neighborhood (PCMH-N) capabilities reported by physician organizations. These audits help BCBSM validate practice capabilities through conversation and documentation review to ensure capabilities marked in place by the practice are accurate.
For example, a practice shares how their test tracking process works in their office. BCBSM then validates the tracking via screenshots provided by the practice to support their process.
The annual audits are significant to The Physician Alliance members since they are used to determine the physician organization’s accuracy factor. Practices must receive a 95% accuracy rate or higher. For the third consecutive year, TPA practices scored 100% accuracy!
Ashley Shreve, director of practice transformations, stated “our practices continue to impress me with their dedication to their patients and by providing best practice workflows. The two practices that were selected for site visits did an outstanding job gathering supporting documentation, as well as verbalizing their processes and procedures to BCBS. The commitment that these offices have to their patients is remarkable and shows how devoted our physicians and staff are to giving their all to our patients.”
Thank you to the physicians, their practice staff and practice resource team members for working together to achieve success with the random BCBSM audits.
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