Provider Quality Improvement Manual (PQIM)
Welcome to the Provider Quality Improvement Manual. The list below links to specific topics; each one contains further information about clinical guidelines, supporting tools for clinicians, useful information for patients, and more!
For questions, or if you would prefer a paper copy of this manual, please call our Quality Improvement Department at 1-800-777-4793 extension 12247.
Note: These guidelines are not intended to replace the role of the clinical judgment by the physician in the management of any disease entity. They are educational guidelines to help assist in the delivery of good medical care. All treatment decisions are ultimately up to the physician.
Primary Care Quality Reports
MVP updates its clinical guidelines at least every two years. The review process will be initiated on a more frequent basis when new scientific evidence or national standards are published. MVP will review all applicable guidelines and update these guidelines accordingly.
The MVP Quality Improvement department has developed several primary care quality reports, produced at the practice site level, which can help you manage your patient population.
- Gaps in Care Report—a prospective report that identifies members who are lacking preventative screenings, well care visits, or immunizations (produced three times a year)
- ER Reports—(produced monthly)
- Recent ER Visits—provides detailed information on members who have utilized the ER in the past month for care
- Multiple ER Visits—a list of members who have utilized the ER two or more times in the past month for care
- Inpatient Report—provides a list of members who were discharged from the hospital during the previous month (produced monthly)
These reports are provided in an electronic format (Microsoft Excel) so that you are able to work with the data based on your particular needs or interest. For more information, contact Michael Farina, Director, Clinical Quality and Reporting, 1-800-777-4793, x12463.
- Adolescent Health
- Back Pain
- Behavioral Health
- Cardiac Care
- Careful Antibiotic Usage
- Caring for Older Adults
- Infectious Disease
- Kidney Care
- Oncology/Cancer Prevention
- Preventive Health
- Quality Improvements in the Clinical Setting
- Women’s Health
Ensuring that members and health professionals are satisfied with MVP Health Care is part of our quality plan. You may request more information about MVP Health Care’s Quality Improvement initiatives, programs, and a report of the organization’s progress in meeting its goals by calling Customer Care Center for Provider Services, Monday through Friday, 8:30 am – 5:00 pm, at 585-325-3114 or 1-800-999-3920. TTY users may call 1-800-662-1220.