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1-833-779-7999

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1-866-620-2520

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

Quality Assurance Program

The Triple-S Quality Improvement Program provides the work structure for the Clinical Quality Division 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:

HEDIS CAHPS/HOS Quality Improvement Program Adverse Events
  • HEDIS quality measures allow us to determine the execution of our plan and compare with national standards.
  • It allows us to monitor our execution and identify opportunities for improvement.
  • The CAHPS and HOS surveys conducted with our affiliates help us to know their experiences with the clinical and administrative services offered by our plan.
  • Quality improvement projects allow us to develop specific strategies to meet the health needs of our affiliates.
  • Adverse Events can cause physical and psychological harms and even death.
  • Adverse Events Identification help us to prevent and reduce health complications of our affiliates.
  • It allows us to monitor hospital’s execution to prevent them.

As part of the quality plan for 2018, we will continue to promote access to preventive services through the use of clinical guidelines, satisfaction with the services received and measuring our execution through HEDIS measures, identifying those areas to be improved.We will promote the continuous participation of 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) 273-1110 Ext. 3056 or 3285

Last update: 10/06/2018

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