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Quality Improvement

Provider Administrative Policy

Commercial Managed Care
Policy Date
August 2006
Revised/May 2008
Provider Type(s)
All Providers  


Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts


Quality Improvement

Our quality improvement projects (QIP) are designed to continuously improve the quality of clinical care and services provided to our members from participating health care providers. By working with health care providers, Blue Cross of Idaho aims to integrate administrative services and health care delivery to improve the quality of care provided to members through data collection and analysis, member input, interventions to improve performance and other necessary means. QIP activities may include, but are not limited to, disease management, specialty-specific programs and other nationally recognized clinical surveys/projects. These goals are achieved by:

Quality of Care and Service Oversight:

  • Input from members on potential clinical or service opportunities.
  • Oversight of delegated entities.
  • Provider medical record review.

Quality Improvement Projects:

  • Collaborate with physicians and representatives regarding quality, priorities and opportunities for improvement.
  • Develop and implement interventions to improve performance.
  • Evaluate the effectiveness of the interventions and modify the interventions for continual improvement.

If you would like to know more about our quality improvement projects, please contact the Blue Cross of Idaho Quality Management department (see PAP100).

Policy History

Date Action Reason
May 2008 Revised Contact list - link

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