Fritz Associates, Inc.
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External Peer Review Mechanics

7/26/2016

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  • Determine Preferred EPR Provider:
    • Routine & Expedited Completion Time
    • Capability to serve as a Hearing Officer
    • Physician Specialty Availability
    • Ability to Perform Peer Review Effectiveness Assessment
    • On & Off-Site Capability & Rates
    • Clinical Department, Group Practice, Medical Staff-wide
    • Evaluation methods;                                                 
    • Stand Behind Review Findings: Calls, Visit Organization/Court
  • Confirm that the EPR Criteria meets your EPR policy
  • Contact the EPR provider to confirm:
    • Reason for the Review & Case Selection 
    • Confidentiality & Indemnification Agreements             
    • Efficient Sample Size & Effective Review Method
    • On/Off-site Determination;
    • Medical Records Format (Electronic/Paper/CD)
    • Due Dates of the Final Report & Report Format
    • Reviewer Credentials, Privileges, Location & Facility 
    • Not-to-Exceed Total Cost
    • Need for Conference Call(s), On-Site meeting, hearing, court appearance  
  • Review with the Clinician Being Evaluated: The Reason for the Review;  The Case Selection, Sample Size, Methodology; The Clinical Reviewer Background; & Their Portion of the Review Cost (if appropriate).
  • Approve & Return EPR Vendor Agreement with Confidentiality, Indemnification & Medical Records. Specify if Records are Destroyed After the Review or Returned to the Hospital/Group Practice. (Agreement Updated every Two Years)
  • Records Sent Electronically Encrypted or Compact Disk Sent via Overnight Courier with Security Code Sent via email with Confirmation Upon Receipt,
  • EPR Vendor to Manage the Process with the CEO, CMO, MSP, Risk or Quality Management per Agreement.
  • Receive Written Report (consider who receives it: MEC, Admin, Legal, with advance verbal preview).
  • Determine if the Report will be Reviewed at the MEC, or in Advance by the Peer Review Committee/Chair or CMO and then Discussed at the MEC.
  • Determine if Follow-up Call or Visit from the Clinical Reviewer is Necessary.
  • Conduct Final Call EPR Vendor to Review Satisfaction with the Process. ​
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