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- NCQA RECOGNITION - MUST PASS ELEMENTS -
SOME EXAMPLES

Maine Medical partners has allowed us to share some of the tools and material they have submitted as part of their application for NCQA recognition. Please click on a link below to view the tool.


Click to view:
Maine Medical Partners NCQA Recognition Requirements Summary & Checklist 


 

Standard 1 - Element A - Access During Office Hours

The practice has a written process and defined standards, and demonstrates that it monitors performance against the standards for:

Factor 1 - Providing same-day appointments
Physician dashboard tracking time to third next available appointment
Tracking open appts. (5 days)
Open Access Scheduling Process

Factor 2 - Providing timely clinical advice by telephone during office hours
Policy for Clinical Advice by Phone during Office Hours
Measuring timeliness for patient phone calls messages
Telephone response time to triage audit

Factor 3 - Providing timely clinical advice by secure electronic messagesduring office hours
Policy for Clinical Advice by Electronic Message during Office Hours

Factor 4 - Documenting clinical advice in the medical record.
Examples of clinical phone and electronic messaging advice
Process for clinical phone and electronic messaging advice

Standard 2 - Element D - Use Data for Population Management

The practice uses patient information, clinical data and evidence-based guidelines to generate lists of patients and to proactively remind patients/families and clinicians of services needed for:

 Factor 1 - At least three different preventive care services
Generated list of patients and reminder for breast cancer screening

Factor 2 - At least three different chronic care services
Generated list of patients and reminder for Asthma screening

Factor 3 - Patients not recently seen by the practice
Generated list of patients not seen in 1 year and  patient reminder 

Factor 4 - Specific medications
Generated list of patients on specific medication
Letter sent to patients on specific medication
Workflow used to identify patients on brand names medications and how patients are informed

Standard 5 – Element B - Referral Tracking and Follow-Up

The practice coordinates referrals by:

Factor 1 - Giving the consultant or specialist the clinical reason for the referral and pertinent clinical information
Referral report to track all referrals in electronic health record.

Factor 3 - Following up to obtain a specialist’s report
Report used to track and follow up on referrals including follow up to obtain  specialists reports (Report had been condensed for MH website and does not contain 7 days of tracking)

Factor 4 - Establishing and documenting agreements with specialists in the medical record if co-management is needed
Document establishing and documenting agreements with specialist
Screen shots of EHR referral and co-management with specialist.


110 Free Street | Portland, Maine 04101 | (207) 661-7001