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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

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.

Last update: 15/10/2020

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