The goal of the MCNA Quality Improvement (QI) Program is to ensure that each member has affordable and convenient access to quality dental care delivered in a timely manner by one of our participating providers. Our QI Program monitors and evaluates the quality and appropriateness of care and service delivery to members and providers through performance improvement projects (PIPs) in both clinical and non-clinical areas, dental record audits, performance measures, surveys, and related activities.

One of our primary objectives is to perform a quality review of key clinical and service indicators through analysis of member and provider data to assess and improve member and provider satisfaction rates. These clinical and service indicators include reviews of:

• Member and provider grievances about care or service
• National Committee for Quality Assurance's (NCQA's) Healthcare Effectiveness Data and Information Set (HEDIS®)
• Application of Clinical Practice Guidelines
• Application of appropriate dental record documentation, and continuity and coordination of care standards
• Health outcome intervention studies or activities
• Member claims and encounters
• Member pre-authorizations requests and referrals

Your office plays a key role in support of our QI Program by making available upon request the dental records of any MCNA member in your care.

To learn more about MCNA's comprehensive QI Program, including your role in quality and periodic member record reviews, please refer to your Provider Manual or call MCNA's Provider Hotline at 1-855-776-6262 (8 a.m. to 7 p.m., Central Time, Monday through Friday).