CMS Beneficiary Protection Case
PROJECT
The QIO complaint process has been the source of several critical reports. QIO surveys revealed dissatisfaction with the outcomes of quality reviews. The most common criticisms of the complaint process; accessibility, responsiveness, effectiveness, and accountability.
SERVICES AND PRODUCTS
Program Management, Project Management
RESULTS
- IRIS’ solution provided CMS / CCSQ a completely redesigned and efficient
case review process. - Provided a conceptual architecture for the Case Review Management Information System (CRMIS) that leverages current CMS IT systems and future Federal electronic health record (HER) initiatives.
- Identified innovative performance measures for quality of service delivery and created new financial reports to measure the effectiveness of beneficiary
protection activities.
