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Oklahoma Administrative Code (Last Updated: March 11, 2021) |
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TITLE 310. Oklahoma State Department of Health |
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Chapter 659. Health Maintenance Organizations |
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Subchapter 3. Examinations |
SECTION 310:659-3-3. Reports
Latest version.
- (a) The quality examiner shall prepare a report based upon the assessment team's findings. One (1) copy of each report shall be submitted to the Department. The report shall contain, at a minimum, the following information:(1) An overview of the HMO's quality assurance program, an evaluation of recent quality assurance studies undertaken by the HMO, and the degree of implementation of the written quality assurance plan;(2) A description of the HMO's quality assurance program;(3) A description of the types and numbers of medical records reviewed, selection criteria, and review methods;(4) A summary of charts that met and did not meet the established review criteria;(5) Recommendations for follow-up, when indicated; and(6) A listing of the names and titles of individuals that conducted and analyzed the review.(b) The HMO shall forward to the Department a complete and unaltered copy of the final report within five (5) working days after the HMO receives the report from the quality examiner.