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Sales Representative

1-833-779-7999

Your call may be directed and answered by a licensed insurance sales agent.

TTD Users

1-866-620-2520

Monday through Sunday, from 8:00 a.m. to 8.00 p.m.

Quality Assurance Program

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The Triple-S Quality Improvement Program provides the work structure to monitor and evaluate the quality of care offered to our beneficiaries.

The program allows us to achieve our corporate commitment to continuously improve the services we offer, through the analysis of quality indicators and the re-evaluation of existing initiatives or the implementation of new initiatives. In addition, the program helps us meet CMS requirements to offer preventive services that benefit our affiliates.

Our Quality Improvement Program has several components:

CLINICAL CARE CLINICAL SERVICES SAFETY OF CLINICAL CARE CHRONIC CARE IMPROVEMENT PROJECT
SNP – Model of Care Quality Initiatives Delegated Activities Claims Validation

Each of these components evaluates different indicators which are monitored under an organizational Quality structure. As part of the program, we will continue to promote access to preventive services using clinical guidelines, satisfaction with the services received and measuring our performance through standardized measures (HEDIS, Star Ratings Program, etc.) identifying those areas to improve. We will promote the ongoing participation of our members in clinical care programs, educational activities and in the integration of physical and mental care.

For more information about our Quality Improvement Program you can contact the Clinical Quality Division by calling 787-749-49490 Ext. 832-3056 or 832-3285.

About us

Written by

We are focused on prevention and on ensuring that our beneficiaries enjoy a healthy and fulfilling life.

As members of the Triple-S Group, the leading insurance company in Puerto Rico, and as an independent licensee of the BlueCross BlueShield Association, we offer a broad portfolio of Medicare Advantage products and services for beneficiaries with Medicare Part A and Part B.

Our aim is to offer all our beneficiaries the best service and health care.

Our Vision

Lead health and well-being in Puerto Rico by delivering a seamless holistic care experience through innovative models, integrative technology, and service excellence.

Our Mission

Enable healthy lives.

Values

  • Accountability: We honor our individual and collective commitments with a sense of urgency.
  • Integrity: We conduct ourselves in an ethical manner in all our actions.
  • Respect: We value the dignity and diversity of our people, and we contribute to their development and well-being.
  • Service Oriented: We endeavor to provide the best quality service to all our constituents.
  • Excellence: We strive to improve ourselves continuously, with the highest levels of efficiency and effectiveness.
  • Innovation –:We foster creativity and experimentation to evolve and create competitive advantage.
  • Community Engagement: We contribute to improving quality of life in the communities we serve.

Member Service

1-888-620-1919

TTY/TDD users

1-866-620-2520

Monday thru Sunday,
from 8:00 am to 8:00 pm

Service for Providers

1-855-886-7474

Monday thru Friday,
from 8:00 am to 5:00 pm

Teleconsulta

1-800-255-4375

Dedicated Teleconsulta for TTY/TDD Callers: 711 | 1-855-209-2639

Teleconsejo

1-877-879-5964
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