Office Site and Medical Record Evaluation Forms
Last Updated: Friday, September 16, 2022
- wpa/ nepa
- cpa/ sepa
- de
- wv
The Office Site and Medical Record Evaluation Forms is only applicable to Pennsylvania, Delaware, and West Virginia.
Quality management nurses conduct practitioner office site quality and medical/treatment record evaluations for any practitioner within its network based on:
- Member dissatisfactions relating to physical accessibility, physical appearance, and adequacy of waiting and/or examination-room space.
- Annual random sampling: Using a statistically valid sampling methodology, practice sites will be selected to have practitioner office site quality and medical/treatment record evaluations performed.
For your convenience, provided below are copies of the forms.
