PSRC of America--Services

<body bgcolor="#FFFFFF" link="#808000" vlink="#808080" alink="#000080"> <p>This page uses frames, but your browser doesn't support them.</p> <table border="0" width="538"> <tr> <td width="534"><a name="Top"></a><small><font face="Arial"><small><a href="#Managed Care Services">MANAGED CARE SERVICES</a><br> <a href="#Educational Development and Training">EDUCATIONAL DEVELOPMENT AND TRAINING</a><br> <a href="#Conference Development">CONFERENCE DEVELOPMENT</a><br> <a href="#Medical Record Review">MEDICAL RECORD REVIEW</a><br> <a href="#Additional Services">ADDITIONAL SERVICES</a><br> <a href="#Clients">CLIENTS</a></small><br> <br> <br> <a name="Managed Care Services"><strong>Managed Care Services</strong></a><br> <br> All our managed care services, including physician credentialing, quality assurance, and utilization management comply with the standards established by the <a href="http://www.ncqa.org">National Committee for Quality Assurance (NCQA)</a>.<br> <br> ONSITE PHYSICIAN OFFICE REVIEW<br> <br> Over 8,000 physician office practice reviews have been carried out<br> for PSRC clients. We have:</font></small><ul> <li><small><font face="Arial">developed and refined instruments for data collection</font></small></li> <li><small><font face="Arial">assessed office environments for safety, cleanliness,<br> accessibility, staffing, scheduling, and confidentiality safeguards;</font></small></li> <li><small><font face="Arial">reviewed medical records for the quality and appropriateness of care:</font></small></li> <li><small><font face="Arial">applied disease management protocols for common diagnoses.</font></small></li> </ul> <p><small><font face="Arial">PRIMARY VERIFICATION OF CREDENTIALS</font></small></p> <p><small><font face="Arial">For clients with either large or small provider networks the PSRC has worked either onsite or at the client's office or in close coordination with client staffs.  For tens of thousands of physicians, through the established PSRC access to national and state databases, the PSRC has:</font></small><ul> <li><small><font face="Arial">confirmed current valid license;</font></small></li> <li><small><font face="Arial">confirmed clinical privileges in good standing at the primary admitting facility;</font></small></li> <li><small><font face="Arial">assured valid DEA or CDS certificate;</font></small></li> <li><small><font face="Arial">confirmed Board certification;</font></small></li> <li><small><font face="Arial">verified work history;</font></small></li> <li><small><font face="Arial">assessed malpractice history and confirmed current and adequate malpractice insurance;</font></small></li> <li><small><font face="Arial">confirmed previous or current state sanctions, restrictions or limitations of scope of practice;</font></small></li> <li><small><font face="Arial">reviewed physician application for correctness, completeness and appropriate attestation;</font></small></li> <li><small><font face="Arial">evaluated client policies and procedures to assure appropriate verification practices and quality assurance mechanisms are in place and functioning.</font></small></li> </ul> <p><small><font face="Arial">FOCUSED PHYSICIAN TO PHYSICIAN REVIEW</font></small></p> <p><small><font face="Arial">PSRC physicians work with HMO providers to help improve the quality of care and the utilization of services for subscribers and their families.</font></small></p> <p><small><font face="Arial">DEVELOPMENT OF REVIEW INSTRUMENTS</font></small></p> <p><font face="Arial"><small>DEVELOPMENT OF QUALITY AND UTILIZATION MANAGEMENT PROTOCOLS</small></font></p> <p align="center"><a href="#Top"><small><font face="Arial"><small>BACK TO TOP</small></font></small></a></p> <hr> <p><a name="Educational Development and Training"><font face="Arial"><small><strong>Educational Development and Training</strong></small></font></a></p> <p><small><font face="Arial">The PSRC has trained thousands of professionals to carry out client specific protocols, reviews, evaluations and assessments.  Thoroughly trained personnel provide the standard of excellence required to carry out professionally designed protocols and assessment tools which seek to evaluate and monitor the quality and level of health care delivery services.</font></small></p> <p><font face="Arial"><small>To that end, the PSRC has trained:</small></font><ul> <li><font face="Arial"><small>Clinical personnel who determine a patient's care needs and the best setting for that care in accordance with federal and state regulations safeguarding patient welfare;</small></font></li> <li><font face="Arial"><small>Home health professionals;</small></font></li> <li><font face="Arial"><small>Hospital discharge planners;</small></font></li> <li><font face="Arial"><small>Registered nurses who conduct site assessments and medical record review for quality and utilization monitoring, level of care assessment, data collection and special studies;</small></font></li> <li><small><font face="Arial">Nursing home, Hospital and Community Service Agency Registered Nurses and Social Workers as patient review assessors for the New York State reimbursement program for nursing facilities.  (See our page on </font><a href="pri-screen.htm" target="_top"><font face="Arial">PRI and SCREEN Information</font></a><font face="Arial"> regarding this program.)</font></small></li> </ul> <p align="center"><a href="#Top"><small><font face="Arial"><small>BACK TO TOP</small></font></small></a></p> <hr> <p><a name="Conference Development"><strong><small><font face="Arial">Conference Development</font></small></strong></a></p> <p><small><font face="Arial">The PSRC has also organized and trained professionals in a variety of conferences on:</font></small><ul> <li><small><font face="Arial">Primary Care and the Management of HIV Infection</font></small></li> <li><small><font face="Arial">Confidentiality and HIV Testing</font></small></li> <li><small><font face="Arial">Working with the Provider Community for Onsite Data Collection</font></small></li> <li><small><font face="Arial">Patient Assessment for Nursing Home Admissions</font></small></li> </ul> <p><small><font face="Arial">Innovative Protocols</font></small></p> <blockquote> <p><small><font face="Arial">The PSRC has been responsible for producing state of the art protocols for the treatment of specific diseases.  Working with the physician and nursing community the PSRC, on behalf of state authority, coordinated and assisted in the publication of critical treatment manuals for the care and treatment of HIV infection.</font></small></p> </blockquote> <p align="center"><a href="#Top"><small><font face="Arial"><small>BACK TO TOP</small></font></small></a></p> <hr> <p><a name="Medical Record Review"><font face="Arial"><strong><small>Medical Record Review</small></strong></font></a></p> <p><font face="Arial"><small>The underpinning for much of PSRC work is medical chart review.  We work in all health care settings including hospital inpatient and outpatient, clinic, private office, nursing home, assisted-living center, mental health facility, day treatment facility, home health, correctional facility infirmary, and others</small></font></p> <blockquote> <p><font face="Arial"><small>TO ASSESS</small></font><ul> <li><font face="Arial"><small>quality or care</small></font></li> <li><font face="Arial"><small>access to services</small></font></li> <li><font face="Arial"><small>level of care</small></font></li> <li><font face="Arial"><small>utilization of services</small></font></li> <li><font face="Arial"><small>appropriateness and accuracy of all billed costs, including cost of drugs</small></font></li> <li><font face="Arial"><small>clinical appropriateness of care</small></font></li> <li><small><font face="Arial">compliance with regulatory procedures</font></small></li> <li><font face="Arial"><small>compliance with practice guidelines</small></font></li> </ul> <p><font face="Arial"><small>TO EVALUATE CLINICAL PROTOCOLS</small></font></p> <p><font face="Arial"><small>TO PERFORM OR VALIDATE ICD-9 or CPT CODING</small></font></p> <p><font face="Arial"><small>TO COLLECT DATA SUCH AS</small></font><ul> <li><font face="Arial"><small>the standardized clinical data sets, HEDIS, etc.</small></font></li> <li><small><font face="Arial">brand and quantity of all pharmaceuticals administered during selected hospitalizations.</font></small></li> </ul> </blockquote> <p align="center"><a href="#Top"><small><font face="Arial"><small>BACK TO TOP</small></font></small></a></p> <hr> <p><a name="Additional Services"><strong><small><font face="Arial">Additional Services</font></small></strong></a><ul> <li><small><font face="Arial">Design and implementation of special studies</font></small></li> <li><small><font face="Arial">Troubleshooting consultation relating to quality and utilization management</font></small></li> <li><small><font face="Arial">Response to regulatory sanctions</font></small></li> <li><small><font face="Arial">Mental health and substance abuse review</font></small></li> <li><small><font face="Arial">Special expertise in AIDS/HIV care</font></small></li> </ul> <blockquote> <p><small><font face="Arial">The PSRC's experience in this complex field goes back more than a decade.  During 1988-1991, a period of rapidly expanding knowledge, the PSRC conducted numerous educational conferences for health care professionals and produced one of the first clinical manuals on the treatment of AIDS and HIV infection under the aegis of the New York State Department of Health.  Working with medical experts in the field of AIDS/HIV care, the PSRC developed and implemented a quality of care, utilization and case management program for HIV patients in AIDS designated hospitals in New York.   More recently, the PSRC has conducted medical record reviews and evaluated clinical protocols in non-hospital settings to assess quality of care and case management for HIV patients.</font></small></p> </blockquote> <p align="center"><a href="#Top"><small><font face="Arial"><small>BACK TO TOP</small></font></small></a></p> <hr> <p><a name="Clients"><font face="Arial"><small><strong>Clients</strong></small></font></a></p> <p><font face="Arial"><small>PSRC clients include:</small></font><ul> <li><font face="Arial"><small>Major insurers</small></font></li> <li><font face="Arial"><small>Managed care companies</small></font></li> <li><font face="Arial"><small>Governmental and regulatory authorities</small></font></li> <li><font face="Arial"><small>Physician provider networks</small></font></li> <li><font face="Arial"><small>Medicaid managed care organizations</small></font></li> <li><font face="Arial"><small>Community health care agencies</small></font></li> <li><font face="Arial"><small>Alternative residential care facilities</small></font></li> <li><font face="Arial"><small>Hospitals and health care facilities</small></font></li> <li><font face="Arial"><small>Pharmaceutical companies</small></font></li> </ul> <p align="center"><a href="#Top"><font face="Arial"><small><small>BACK TO TOP</small></small></font></a></p> <p align="center"> </p> <p align="center"><small><small><small><a href="who-we-are.htm" target="_top"><font face="Arial">Who We Are</font></a><font face="Arial">  |   </font><a href="services.htm" target="_top"><font face="Arial">Services</font></a><font face="Arial">  |  </font><a href="exec-director.htm" target="_top"><font face="Arial">Management Team</font></a><font face="Arial">  |  </font><a href="confidentiality.htm" target="_top"><font face="Arial">Confidentiality</font></a><font face="Arial"> <br> </font><a href="chairmans_message.htm" target="_top"><font face="Arial">Chairman's Message</font></a><font face="Arial">  |  </font><a href="pri-screen.htm" target="_top"><font face="Arial">PRI/SCREEN</font></a><font face="Arial">  |  </font><a href="contact-us.htm" target="_top"><font face="Arial">Contact Us</font></a><font face="Arial">  |  </font><a href="links.htm" target="_top"><font 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