Skip to main content

Quality matters

You deserve to get the highest quality care. And we work with your provider to make sure that happens. Together, we're committed to giving you the best health care experience possible.

Have a question? 

Just call Member Services at  1-855-232-3596 (TTY: 711).  We’re here for you 24 hours a day, 7 days a week.

Providing you with quality service

Providing you with quality service

Making sure you get the highest quality care when you need it is our goal. We partner with local providers who understand your needs. And the National Committee for Quality Assurance (NCQA) continues to accredit us. This is because we score high on:

 

Healthcare Effectiveness Data and Information Set (HEDIS®) scores

Healthcare Effectiveness Data and Information Set (HEDIS®) scores

We want to improve access to quality health care for our members. You have access to a large network of providers. This includes obstetrician/gynecologists (Ob/Gyns), pediatricians, NJ’s top hospitals and community groups to help you stay your healthiest . HEDIS scores help us see if we’re meeting our goals. You can view our latest HEDIS results and learn more about HEDIS on the NCQA website.

 

Learn more about HEDIS

 

2020 HEDIS results (PDF)

Member satisfaction surveys

Your answers on our Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys are private. We use the results of those surveys to improve the ways we take care of our members. You can view our member satisfaction survey results on this page. Or you can reach out to Member Services to learn more. Just call 1-855-232-3596 (TTY: 711).

Our goals and objectives

Our goals and objectives

The Quality Improvement program includes these goals:

 

  • To promote and build quality into the daily operations and policies of the health plan 
  • To continually check and assess your needs, care and services to ensure you’re getting quality care at the right time
  • To find areas for improvement and act on them
  • To encourage patient safety through seasonal communications to you (for example, flu mailers)
  • To ensure we meet or exceed the highest quality by following local, state and federal regulatory requirements and accreditation standards
  • To provide support for the things that affect health, like rides, food and housing support

Our services

Our services

The program provides many services, which include:

 

  • Offering extra benefits to encourage wellness, including a preventive care rewards program
  • Sending you helpful postcards and newsletters about your health
  • Reviewing primary care physician (PCP) and ob/gyn offices to make sure they meet state standards
  • Reviewing the quality of our services
  • Reminding you and your provider about preventive health care
  • Measuring your satisfaction with your provider and health care services
  • Scanning phone calls to ensure that we answer your call quickly and that you get the correct info
  • Working with your providers to ensure they get all the info they need from us to provide you with quality care
  • Reviewing the quality of our services
  • Offering population health services, including info about chronic illnesses and one-on-one support for social determinants of health (conditions in the places where you live, learn, work, and play that affect your health)

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).