QI Program

We are committed to the provision of a well-designed and well-implemented Quality Improvement (QI) program. Our culture, systems and processes are structured around this mission to improve the health of all enrolled members.

Scope
The scope of the QI Program is comprehensive and addresses both the quality and safety of clinical care and quality of services provided to CeltiCare Health's members including medical, behavioral health, dental and vision care. We incorporate all demographic groups, care settings, and services in QI activities, including preventive care, emergency care, primary care, specialty care, acute care, short-term care, long-term care (depending upon CeltiCare Health's products), and ancillary services.

Goals & Objectives
Our primary quality improvement goal is to improve members’ health status through a variety of meaningful quality improvement activities implemented across all care settings and aimed at improving quality of care and services delivered.

Credentialing Standards

For consideration to participate in the CeltiCare Health network, all licensed physicians and other licensed healthcare professionals who have an independent relationship with CeltiCare Health must complete an application for participation and submit copies of applicable supporting documentation.

Cultural Competency Plan
CeltiCare Health is committed to establishing multicultural principles and practices throughout its organizational systems of services and programs. That mission is supported by facilitating the process by which CeltiCare Health can respond to the health care needs of all individuals, regardless of their ethnic, cultural, religious beliefs or language. Our Cultural Competency plan is reviewed and updated annually.

Click here to see the full plan.

Participation in QI
CeltiCare Health requires providers and practitioners to cooperate with all Quality Improvement activities, as well as allow the use of provider and/or practitioner performance data, to ensure the success of the QI Program. The CeltiCare Health QI Program is outlined in the QI Program Updates and is available upon request. If you are interested in learning more about CeltiCare Health's QI Program, please contact CeltiCare Health at 1-855-678-6975 and ask to speak with the Quality Improvement Department. 

CAHPS®

CeltiCare Health is dedicated to partnering with providers to help maximize opportunities to improve patient care and the member’s experience with their health plan and their providers. We use a tool titled CAHPS® (Consumer Assessment of Healthcare Providers and Systems) to gauge member experience. View our Provider Tips to enhance relationships with patients and improve CAHPS® scores.

View our Provider Tips to enhance relationships with patients and improve CAHPS® scores.

CeltiCare Health is proud to have achieved Health Plan Accreditation from NCQA.