Appointment Access and Office Wait Time: Acceptable time standards for patients making appointments and for wait times in the office.
Care Management: Information on the Health Pregnancy, Pediatric Case Managment, Transplant Case Management, Adult Case Management, Restricted Recipient and Medicare/Medicaid Specific Programs and Benefit Appeals.
Centers of Excellence: Information on this program and access to a list of approved providers. Includes bariatric care and organ transplant programs.
Clinic Site Survey: Procedures for conducting a practitioner office site-related complaint survey.
Medical Policies: Find current versions of Medica utilization management (UM) policies, coverage policies, drug management policies, Institute for Clinical Systems Improvement (ICSI) guidelines, and Medica clinical guidelines.
Member Rights and Responsibilities: Outlines Medica members' legal rights and responsibilities.
Medical Record Review: Examination and improvement of medical practice performance.
Quality Guidelines and Improvement: Encompasses a wide range of clinical and service quality initiatives.
Quality and Cost Transparency: We offer our members various programs and tools to explore cost and quality information to help them shop for care.
Reporting Obligations: Find information and forms intended for Medica network providers to use in responding to reporting obligations required by law, contract or accreditation standards (including those required by the National Committee for Quality Assurance, or NCQA®).