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Does your Office Meet Superior's Appointment Availability Access and Office Site Standards?

Date: 12/06/16

Superior has developed Appointment Availability and Office Site Standards to ensure all practices are accessible, safe and available to provide quality care to members. These standards were formulated using the National Committee for Quality Assurance (NCQA), Texas Department of Insurance (TDI) and Texas Health and Human Services Commission (HHSC) requirements.

Superior has established appointment availability time frames to include routine visits with primary care, specialists and behavioral health providers. Maximum wait times for scheduled and walk-in appointments were also determined. For detailed information about Superior’s Appointment Availability Standards please review: Appointment Availability Standards

Superior may evaluate standards as well as conduct office site visits at any time to ensure compliance.  Site visits may also be completed as a response to an event or to investigate a complaint. This may include a particular service or a facility evaluation related to the complaint. Any or all performance standards and thresholds may be reviewed during a complaint investigation. Standards for office sites are measured utilizing guidelines in the following areas:

Physical Accessibility   

  • Is there ease of entry into the building or practice site?
  • Is there accessibility of space within the building or practice site?
  • Is there ease of access for patients with physical disabilities?
     

Physical Appearance

  • Is the building or practice site clean?
  • Are spaces properly lit?
  • Are there safety concerns?
     

Adequacy of Waiting and Examination Room Space

  • Do the waiting and examination rooms have adequate space for patients?
  • Do the waiting and examination rooms have adequate seating?
     

Adequacy of Medical/Treatment Record Keeping

  • Are documents/files with protected health information securely stored and out of plain sight?
  • Are patient files documented timely and accurately?
  • Are best practices for documentation being utilized?
  • Are confidentiality and security protocols in place and being practiced?
     

If you would like more information regarding office site surveys or the adopted guidelines for office sites from Superior’s Quality Improvement Committee, refer to the Superior Provider Manual or the Provider Resources page.