DCS Comprehensive Health Plan

Inter-Rater Reliability Testing

Policy No.

Responsible Area

Last Date

Effective Revised

HS-CC-01

Health Coordination

08/31/2023

08/31/2023

Statement/Purpose

Inter-Rater Reliability (IRR) testing is utilized as a mechanism to monitor and evaluate comprehension of medical criteria, consistent decisions and to ensure accurate and consistent application of the criteria among all staff involved with the process. Inter-Rater Reliability testing is conducted in an effort to:

  • Minimize variation in the application of clinical guidelines;

  • Evaluate staff ability to identify potentially avoidable utilization;

  • Evaluate staff ability to identify quality of care concerns;

  • Evaluate staff ability to triage, systematically examine and finalize quality of care concerns;

  • Target specific areas most in need of improvement; and

  • Identify staff needing additional training.

Definitions

[List definitions not commonly known that are specific to the policy]

Policy

[Policies are the guiding principles and/or rules that ensure consistency and compliance with DCS CHP’s mission, values and strategic goals]

Procedure

[Procedure are high-level actions that guide adherence to policy. Procedures describe the methods used to comply with policy]

Reviewed and Revised Date (Month/Year)

Reason for Review

Revision Description

02/2024

Annual Review

Added updates based upon ACOM 103 revisions and updated reporting requirements.

03/2022

Annual Review

Added and revised pertinent information required for health plan integration.