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Quality Improvement Program

The Quality Improvement (QI) Program is an important part of Carolina Complete Health. The program creates plans, puts those plans into action, and measures efforts to improve your health and safety. 

The QI Program monitors the quality of care and services provided in the areas below:

  • Making sure members get the care they need, when and where they need it
  • Making sure that members are receiving quality care
  • Cultural needs of our members
  • Member satisfaction
  • Patient safety and privacy
  • Offering a wide variety of provider specialties
  • Health plan services members are using

The goal of the QI program is to improve member health, safety, and satisfaction. This is achieved through many different activities. Some of our Quality Improvement goals include the following: 

  • Good health and quality of life for all members
  • Member services meet industry-accepted standards of performance
  • Provide members with Preventive Care reminders annually
  • Member experience meets Carolina Complete Health’s expectations
  • Compliance with state and federal laws and regulations
  • Evaluate the quality of health care by looking at certain performance measures
  • Member satisfaction meets Carolina Complete Health’s targets

For questions about the QI Program and our progress on meeting goals, call the Member Services department at 1-833-552-3876 (TTY: 711) and ask to be connected to the quality department.

The QI Program also reviews services provided to our members. We have clinical practice guidelines for certain conditions. If you would like a copy of these guidelines or need more information about programs by calling 1-833-552-3876 (TTY: 711).

Information and/or a full copy of Carolina Complete Health’s current QI Program Description is available upon request by calling 1-833-552-3876 (TTY: 711).