Home > Terms > English, UK (UE) > External quality review organisation
External quality review organisation
Is the organisation with which the State contracts to evaluate the care provided to Medicaid managed eligibles. Typically the EQRO is a peer review organization. It may conduct focused medical record reviews (i.e. Reviews targeted at a particular clinical condition) or broader analyses on quality. While most EQRO contractors rely on medical records as the primary source of information, they may also use eligibility data and claims/encounter data to conduct specific analyses.
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- Part of Speech: noun
- Synonym(s):
- Blossary:
- Industry/Domain: Insurance
- Category: Medicare & Medicaid
- Company: Centers for Medicare & Medicaid Services
- Product:
- Acronym-Abbreviation:
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