Independence is dedicated to maintaining the highest standard of care and
service for our members, providers, and the communities we serve. Our Quality Management Program website
includes a description of our Quality Management Program, including program
goals, objectives, and activities to improve clinical, network, and service
quality.
- Access and availability standards. Independence standards
ensure that our managed care networks are adequate to meet the needs of our
members with respect to location and appointment accessibility for primary and
specialty care as well as urgent and emergency care, in accordance with
applicable regulatory requirements.
- Member rights and responsibilities. All Independence
members have defined rights and responsibilities.
- Privacy and confidentiality. Independence, our
contractors, and our affiliates are required to protect the privacy and
confidentiality of our members? personal and health information in accordance
with state and federal regulatory requirements.
- Utilization review. It is the policy of Independence that
all utilization review decisions are based on the appropriateness of health
care services and supplies, in accordance with Independence?s definition of
medical necessity and the benefits available under the member?s coverage.
- Medical record-keeping standards. Well-maintained medical
records are critical to facilitate communication, continuity, coordination, and
an effective plan of care. Accordingly, Independence standards require that
medical records are maintained in a manner that is current, detailed, and
organized as required by applicable regulatory requirements.
Please review these above-listed standards with your staff to ensure that
your office maintains the required access, documentation, and quality care
expected of our network providers.
Information about our Quality Management Program and these standards can
also be found in the Provider Manual for Participating Professional
Providers (Provider Manual) and the Hospital Manual for Participating
Hospitals, Ancillary Facilities, and Ancillary Providers (Hospital
Manual), which are available through the NaviNet® web
portal. Paper copies of the Provider Manual and Hospital
Manual can be ordered by submitting an online request or by calling the Provider Supply Line at
1-800-858-4728.
For more information about our Quality Management Program and our progress
in meeting program goals, please visit our website or call Customer Service at
1-800-ASK-BLUE. Members can request the same information by
calling Customer Service.
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independent company.