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PHO Average Audit Score Over 99%

September 22, 2016
PHO is delegated for credentialing by all commercial payers PHO contracts with, including the three Medicaid managed care organizations in Iowa. PHO is audited annually by each payer, including a review of 16-30 initial and recredentialing files, policy and procedure documents, monthly monitoring and committee minutes. Each payer has slightly different requirements and PHO ensures compliance with all of them, in addition to NCQA requirements to continue CVO accreditation. Over the past five years, PHO has an average audit score of over 99%. PHO was recently audited by Midlands Choice and received a score of 100% in all areas!