Site Reviews

Site reviews ensure that all primary care provider (PCP) sites meet the prescribed standards of the California Department of Health Care Services (DHCS)/Managed Care Quality and Monitoring Division (MCQMD).

• An initial Facility Site Review (FSR) is part of the credentialing process. New PCP sites must pass their initial FSR before receiving Alliance member assignments.
• The Alliance conducts an initial Medical Record Review (MRR) within 90 calendar days following the first member assignment. The Alliance conducts a periodic full-scope FSR and MRR at a minimum frequency of every three years thereafter.
• Approximately every 18 months, the Alliance performs an Interim Monitoring Review via site visit or an attestation form to be filled out and returned.
• A Physical Accessibility Review Survey (PARS) evaluates the level of physical accessibility of the health care site. The PARS is conducted as part of every PCP FSR. It is also required as an independent review process for specialists and allied providers serving a high volume of Medi-Cal members who are part of the Seniors and Persons with Disabilities (SPD) population.

DHCS-Certified nurse reviewers conduct the FSR and MRR and score them with standardized DHCS guidelines and audit tools.

The purpose of the reviews is to ensure that the clinic:

• Provides appropriate primary health care services.
• Has consistent processes that support continuity and coordination of care.
• Maintains patient safety standards and practices.
• Operates in compliance with applicable local, state, and federal laws and regulations.

All plan training video: