Quality Improvement Program Posted on September 26, 2018 at 9:28 am.Written by advantage_admin The Triple-S Quality Improvement Program provides a formal continues work structure to monitor and evaluate the quality of care offered to our beneficiaries. The Quality Improvement Program allows us to achieve and keep our corporate commitment to guarantee the continuous improvement of the services we offer to our affiliates. The analysis of quality indicators, the re-evaluation of existing initiatives, identification and resolution of barriers and the implementation of new initiatives help us to guarantee the best quality of services and satisfaction of our members. In addition, the Quality Improvement Program helps us to meet CMS requirements to offer preventive services that benefit our affiliates. Our Quality Improvement Program has several components: CLINICAL CARE SERVICES SAFETY CARE IMPROVEMENT PROJECTS Model of Care for members with Special Needs PlanClinical AuditsSatisfaction Surveys Monitoring of Delegated Services Quality initiatives to monitor the safety of our members Quality Improvement Project for Members with chronic conditions Each of these components evaluate different indicators which are monitored under an organizational Quality structure. As part of our program, we will continue to promote access to preventive services using standardized clinical guidelines by clinical organizations. For us, in Triple S, satisfaction with the services received is our priority. This is why we measure our performance through metrics established by CMS such: HEDIS, CAHPS, Star Ratings Program, among other, identifying those areas to improve and taking actions in identified opportunity areas. We will continue promoting the ongoing participation of our affiliates 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 Quality Improvement Department by calling 787-749-4949 Ext. 832-3285. About us Posted on September 21, 2017 at 4:43 pm.Written by advantage_admin We are focused on prevention and on ensuring that our beneficiaries enjoy a healthy and fulfilling life. As members of Triple-S, 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. Our Values Respect We believe everyone deserves to be valued and treated with dignity. Integrity We believe in honesty, truthfulness, and adherence to the highest ethical standards. Inclusion We believe health equity is right and that helping everyone belong makes us smarter and stronger. Imagination We believe embracing new and different ideas helps us advance health together. Courage We believe speaking up and taking the right action- even when it’s hard – is how we get better. Excellence We believe in driving high-quality results that make our customers love us.