The Basics

This mandatory standard requires that your DTM program provides feedback to those providers that participate in the program as needed in order to improve quality of care and to coordinate the care delivered to participating consumers.  That feedback might take the form of practice profile information or communication to providers about specific performance issues.

Management Tips

Your governing policy and procedure or program description for this standard should provide members of your staff with criteria for providing feedback to participating providers.  Your policy may provide for a variety of methodologies of communicating with providers, including letters, reports, with a consumer drug therapy management record.

URAC Accreditation Tips

This is a mandatory standard.

For the desktop review, you should submit the applicable policy and procedure, as well as samples of the feedback that you provide to participating providers via complaint logs, criteria, or practice profile reports.

The on-site reviewer will interview clinical staff about they provide feedback to participating providers.  In addition, he/she will examine reports to providers and/or consumer records for evidence of contacts with providers, particularly in urgent situations.