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California Lub Koom Haum Saib Xyuas Kev Ruaj Ntseg Sab Nraud​​  

Cal EQRO​​  -​​  Daim Ntawv Qhia Txog Kev Txhim Kho Kev Ua Haujlwm​​ 

As required by Title 42, Code of Federal Regulations, Part 438, Subpart E, the Department of Health Care Services contracts with an External Quality Review Organization (EQRO).  The EQRO conducts reviews of Mental Health Plans (MHPs) to analyze and evaluate information related to quality, timeliness, and access to Specialty Mental Health Services (SMHS) provided by California’s 56 MHPs and/or their subcontractors to Medi-Cal beneficiaries. California EQRO for the Medi-Cal SMHS Program is Behavioral Health Concepts (BHC), Inc.​​  

Kev tshuaj xyuas EQRO muaj xws li kev mus ntsib hauv tsev kawm ntawv, cov neeg siv khoom (cov neeg tau txais txiaj ntsig) thiab cov tswv cuab hauv tsev neeg tsom mus rau pawg, MHP thiab cov neeg ua haujlwm pabcuam tsom mus rau pawg, kev tshuaj xyuas cov ntaub ntawv thiab kev tshaj tawm, kev tshuaj xyuas cov ntaub ntawv, thiab kev ntsuam xyuas ntawm MHP Performance Improvement Projects (PIPs). PIP yog ib qho kev mob siab rau txhawm rau txhim kho kev tswj hwm lossis kev kho mob tshwj xeeb txhawm rau txhawm rau txhim kho kev nkag mus thiab zoo ntawm SMHS. MHPs tuav tsawg kawg ob lub PIPs nquag nyob rau ib lub sijhawm nrog ib qho tsom mus rau thaj chaw kho mob thiab lwm qhov ntawm thaj chaw tsis muaj chaw kho mob.​​ 

Txhua qhov kev tshuaj xyuas EQRO tau sau tseg hauv ib daim ntawv qhia MHP tus kheej. Cov ntaub ntawv suav nrog hauv MHP cov ntawv tshaj tawm tus kheej kuj tseem suav nrog hauv daim ntawv tshaj tawm txhua xyoo thoob plaws lub xeev. Ntxiv rau cov ntawv tshaj tawm MHP tus kheej thiab daim ntawv tshaj tawm txhua xyoo thoob plaws lub xeev, BHC tshaj tawm cov ntaub ntawv PIP peb lub hlis twg. Cov ntawv ceeb toom EQRO tau tshaj tawm rau ntawm BHC Internet Web site thiab tuaj yeem pom nyob rau hauv Daim Ntawv Qhia thiab Cov Ntsiab Lus Tab.​​ 

Lub Sij Hawm Tshwj Xeeb thiab Cov Txheej Txheem # 3 xav kom lub xeev muab EQRO cov ntaub ntawv PIP peb lub hlis twg thiab cov ntawv qhia txhua xyoo rau Lub Chaw Pabcuam Medicare thiab Medicaid (CMS).​​ 

rov qab mus rau nplooj ntawv Cov Ntaub Ntawv Kho Mob Puas Siab Puas Ntsws​​