Therapy Network of New Jersey is pleased to announce the implementation of its new Quality Bonus Program for its contracted Providers (“Program”).
The Program seeks to promote, from its Network Providers, the highest quality of service and operations in the most cost-effective manner. In order to do so, there are certain criteria that will be implemented to allow all providers the opportunity to achieve the best results.
The Network will be evaluated based on their compliance with the following criteria Utilization, Encounter Submission and Quality of Service.
It’s measured as the percentage of the authorizations requested by a Provider that at least had one encounter submitted. This allows TNNJ to ensure that all services requested for a patient were provided by the Therapist.
This is a contractual obligation between TNNJ and their providers, to report the services rendered to the Health Plan and the State. This measure will consider as an Under-utilizers, those providers with an average of less than 3 visits per authorization.
It measures the complaints of patients received from services provided by a TNNJ provider. Since TNNJ is aiming for excellence any provider that had a valid complaint will received a reduction of their Bonus
Other quality measures will be implemented in the near future.