Site Reviews
Reviews are performed on-site at the Managed Care Organization (MCO)/Prepaid Inpatient Health Plan (PIHP) health care delivery system sites to assess the physical resources and operational practices in place to deliver health care. There are various components of a site review such as desk audits, emergency site visits, profiling, compliance reporting requirements, and other quality and program integrity review activities. The final report is reviewed by the Department of Health Care Policy & Financing in order to make recommendations for contract changes and for future audit process improvement.