Quality Matters at Universal

Universal Health Care wants to make sure that we provide health care to meet our members' needs. We have developed a quality program to continuously improve the care and services our members receive. Here are some of our quality activities:

Physician and Providers:

We look at our providers carefully before they see our members. We review their history of patient care and later, we will look at all the information about how they provide care before we approve them to continue to see our members. We also look at provider offices to make sure they meet all the rules for access, safety, and medical records. As our members see UHC’s primary care providers, nurses will be looking at some medical records to see if the providers are doing a good job in taking care of our members and offer help or advice if they need it.

Quality of Care:

Besides reviewing the providers’ medical records, we also look at any concern or problem our members have with any provider and work with the providers to improve the care and service they provide. When members call Member Services with a problem, or if we discover a problem, we will find out what happened and help to fix the problem. UHC also has a group of physicians from the network that looks at any problems with quality of care, and also the improvements that are being made.

Quality programs:

Although we don’t provide care directly to our members, we are developing programs to improve the care they receive. We will be looking at the types of health problems our members have and make sure they have information they need to help take good care of themselves. We will also talk with the physicians to see what we can do to help them take better care of you.

Quality of Service:

UHC also looks at the service to our members. We check how well we answer members’ phone calls and how well we answer questions. We also make sure we respond to member requests in a timely manner. And we make sure that our members are treated courteously and respectfully by UHC and its providers.

Quality Review:

UHC has a group of managers that meets regularly to talk about the quality of care our members receive. All of UHC’s departments are part of this group, and it includes the medical director and top managers. We look at all the information about the care and services our members receive and plan ways to improve them.

Member Input:

Members who have ideas about ways to improve our care and services may contact us through Member Services to tell us their ideas. If there is a specific problem, Member Services can help solve it. If there is a general suggestion, Member Services can forward the idea to the Quality Department. We welcome our members’ input into our quality process and want to make sure we meet their needs.