Standards of Care

Independence Blue Cross monitors and objectively evaluates standards and quality of care for our members through the following programs and standards:

Quality Management Program
The Quality Management (QM) Program monitors and objectively evaluates the quality and effectiveness of care for our members.

Access and Availability Standards
Access and Availability Standards ensure managed care networks are sufficient in number, type, and geographic location of providers.

Member Rights and Responsibilities
Members have clearly defined rights and responsibilities relating to care, information, conduct, and other issues.

Privacy and Confidentiality
Understand how we comply with the Privacy Rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which requires us to take additional measures to protect personal information and to inform our members about those measures.

Medical Records Keeping Standards
Established medical record keeping standards facilitate the delivery of continuous and coordinated medical care.

Utilization Review
Review our policy regarding physician incentives for Utilization Management decisions.