Quality Management Program

Independence Blue Cross uses its Quality Management program to systematically monitor and objectively evaluate the company’s quality, efficiency, and effectiveness.

Program Activities

The following is a list of the Quality Management program’s main tasks:

  • provide tools and information to assist network providers in developing and maintaining a high standard of care;
  • manage partnerships with network providers;
  • monitor and evaluate the care our members receive;
  • suggest improvements to medical policies;
  • oversee provider credentialing;
  • oversee various processes for hearing grievances and appeals;
  • collect member suggestions for quality initiatives;
  • monitor aspects of care based on the demographics of members served (i.e., age, sex, and health status);
  • investigate and track potential quality–of–care concerns through the recredentialing, grievance and appeal, and peer review processes.

Member safety

We use plan–wide activities that increase member safety initiatives and reduce medical and medication errors. These activities include communicating information through mailings and newsletters.

Quality improvement

Information about our Quality Improvement program is available to members and providers. Upon request, we’ll provide a description of our program and a report on progress.

Provider requests, call 1-800-227-3119 for HMO or 1-800-332-2566 for PPO. Member requests, call the Member Services number listed on back of the ID card.

Additional information can also be found on our Provider News Center.

Quality Management Program Information