Peer Review & Performance Improvement (#2)

Question 1

Who is a peer?

Answer 1

A peer is an individual with similar training, background or credentials as the applicant.

Question 2

Hospital PR Process

Answer 2

TJC: FPPE with peer review
HFAP: Peer review required (QAPI- Quality Assurance & Performance Improvement)
AAAHC: 2 peer reviews required for recredentialing

Question 3

MCO PR Process

Answer 3

NCQA: P&P define process
URAC: Peer review when certification is not issued through initial clinical review or initial screening