Ambulatory Medical Record Review Process
Lovelace Health Plan nurse reviewers conduct Ambulatory Medical Record Review (AMRR) for all Lovelace network Primary Care Physicians (PCPs), Physician’s Assistants and Clinical Nurse Practitioners supplying primary care. This process was created as a quality improvement mechanism to track and trend appropriate and timely documentation in the medical record.
The audit tool for the record review consists of a three-part assessment and is available to practitioners prior to the evaluation of the site. Typically three charts are reviewed during this assessment. In order to pass the audit, the provider must meet the Company’s threshold of 85% for the assessment tool. Each question on the tool is referred to as a QID or quality indicator and is generally scored at 1 point per QID.
The three components reviewed as part of the AMRR process include:
- Baseline Data (Appropriate and Timely Documentation Practices)
- Continuity of Care
- Screenings and Preventive Health
The findings from the medical record audit may identify opportunities for improvement in medical record keeping practices. The nurse reviewer will identify these to the office practice and offer both recommendations and educational materials to the site/practitioner at the time of the review. A follow-up letter is mailed to the facility/practitioners regarding the outcome of the review. This letter identifies the failed areas of the audit and expectations for a re-audit within six months if needed.
Audit results are reported to the Credentialing Committee and are considered at the time of the provider’s recredentialing.
Click here to download the Ambulary Medical Record Review (AMRR) Tool.
For more information or if you have questions about the AMRR process, please contact the Quality Management nurse reviewers at 505.228.7584 or 505.903.9059.