DCS Comprehensive Health Plan

Peer Review

Statement/Purpose

DCS Comprehensive Health Plan (DCS CHP) participates in a peer review process to address provider quality of care and service issues.

Scope

The Peer Review process addresses matters where there is evidence of a quality deficiency in the care or service provided, or the omission of care or service, by a participating or nonparticipating health care provider. These issues are addressed in a confidential forum by peers.

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]