Common use of Peer Review and Quality Assurance Clause in Contracts

Peer Review and Quality Assurance. Provider shall conduct its peer --------------------------------- review and quality assurance activities in a manner that is consistent with maintaining the confidentiality of the related processes, actions, and documentation. (a) Provider shall designate a committee of dentists to function as a dental peer review committee to review credentials of potential dentist recruits, periodically review the credentials of Provider's existing dentists, determine the practice privileges of the dentists retained by Provider, perform quality assurance, utilization review, and Provider profiling functions, and otherwise resolve dental competency issues. The dental peer review committee shall function pursuant to formal written policies and procedures established by Provider upon consultation with and the assistance of Service Company. (b) Provider also shall adopt a quality assurance program to monitor and evaluate the quality and cost-effectiveness of the Dental Care provided by the dentist personnel of Provider and other non-dentist personnel providing Dental Care under the supervision of Provider's dentists. Upon request of Provider, Service Company shall provide administrative assistance to Provider in performing its quality assurance activities. (c) Provider shall cooperate fully with Service Company in an effort to achieve and maintain full accreditation status for Provider. For purposes of facilitating accreditation and other related processes and without limiting Provider's responsibilities under the preceding sentence, Provider shall develop and maintain a philosophy of practice and a set of practice guidelines which are acceptable to the Policy Board. Provider shall cause all personnel retained by it to abide by such philosophy and guidelines at all times. (d) Provider shall, at the direction of the Policy Board, support the development, maintenance, and operation of a patient concerns and claims recording, reporting, review, resolution, and tracking process which is acceptable to the Policy Board. Provider shall cause all personnel retained by it to comply fully with such process at all times. (e) Provider shall, with the assistance of Service Company, develop a set of quality standards and utilization, process monitoring, and reporting guidelines. Provider shall cause all personnel retained by it to comply with such standards and guidelines.

Peer Review and Quality Assurance. Provider shall conduct its peer --------------------------------- review and quality assurance activities in a manner that is consistent with maintaining the confidentiality of the related processes, actions, and documentation. (a) Provider shall designate a committee of dentists to function as a dental peer review committee to review credentials of potential dentist recruits, periodically review the credentials of Provider's existing dentists, determine the practice privileges of the dentists retained by Provider, perform quality assurance, utilization review, and Provider profiling functions, and otherwise resolve dental competency issues. The dental peer review committee shall function pursuant to formal written policies and procedures established by Provider upon consultation with and the assistance of Service Company. (b) Provider also shall adopt a quality assurance program to monitor and evaluate the quality and cost-effectiveness of the Dental Care provided by the dentist personnel of Provider and other non-dentist personnel providing Dental Care under the supervision of Provider's dentists. Upon request of Provider, Service Company shall provide administrative assistance to Provider in performing its quality assurance activities. (c) Provider shall cooperate fully with Service Company in an effort to achieve and maintain full accreditation status for Provider. For purposes of facilitating accreditation and other related processes and without limiting Provider's responsibilities under the preceding sentence, Provider shall develop and maintain a philosophy of practice and a set of practice guidelines which are acceptable to the Policy Board. Provider shall cause all personnel retained by it to abide by such philosophy and guidelines at all times. (d) Provider shall, at after consultation with Service Company and consideration of the direction recommendations of the Policy Board, support the development, maintenance, and operation of a patient concerns and claims recording, reporting, review, resolution, and tracking process which is acceptable to meets the Policy Boardquality standards of Service Company. Provider shall cause all personnel retained by it to comply fully with such process at all times. (e) Provider shall, with the assistance of Service Company, develop a set of quality standards and utilization, process monitoring, and reporting guidelines. Provider shall cause all personnel retained by it to comply with such standards and guidelines.

Peer Review and Quality Assurance. Provider shall conduct its peer --------------------------------- review and quality assurance activities in a manner that is consistent with maintaining the confidentiality of the related processes, actions, and documentation. (a) Provider shall designate a committee of dentists to function as a dental peer review committee to review credentials of potential dentist recruits, periodically review the credentials of Provider's ’s existing dentists, determine the practice privileges of the dentists retained by Provider, perform quality assurance, utilization review, and Provider profiling functions, and otherwise resolve dental competency issues. The dental peer review committee shall function pursuant to formal written policies and procedures established by Provider upon consultation with and the assistance of Service Company. (b) Provider also shall adopt a quality assurance program to monitor and evaluate the quality and cost-effectiveness of the Dental Care provided by the dentist personnel of Provider Provider’s dentists and other by non-dentist personnel providing Dental Care under the supervision of Provider's ’s dentists. Upon request of Provider, Service Company shall provide administrative assistance to Provider in performing its quality assurance activities. All costs and expenses incurred in connection with this Section 5.5(b) shall be deemed Clinic Expenses. (c) Provider shall cooperate fully with Service Company in an effort to achieve and maintain full accreditation status for Provider. For purposes of facilitating accreditation and other related processes and without limiting Provider's ’s responsibilities under the preceding sentence, subject to Section 3.3, Provider shall (i) develop and maintain a philosophy of practice and a set of practice guidelines which are reasonably acceptable to the Policy Board. Provider shall , and (ii) cause all personnel retained by it to abide by such philosophy and guidelines at all times. (d) Provider shall, at the direction of the Policy Board, shall support the development, maintenanceRisk Management Procedures implemented pursuant to this Agreement, and operation of a patient concerns and claims recording, reporting, review, resolution, and tracking process which is acceptable shall take all actions related to the Policy Boardsuch Risk Management Procedures as may be reasonably requested by Service Company. Provider shall cause all personnel retained by it to comply fully with such process at all times. (e) Provider shall, with the assistance of Service Company, develop a set of quality standards and utilization, process monitoring, and reporting guidelines. Provider shall cause all personnel retained by it to comply with such standards and guidelines. (f) Provider shall, with the assistance of Service Company, develop patient grievance procedures to the extent not specifically addressed in this Agreement. Provider shall cause all personnel retained by it to comply with such procedures.

Peer Review and Quality Assurance. Provider shall conduct its peer --------------------------------- review and quality assurance activities in a manner that is consistent with maintaining the confidentiality of the related processes, actions, and documentation. (a) Provider shall designate a committee of dentists to function as a dental peer review committee to review credentials of potential dentist recruits, periodically review the credentials of Provider's ’s existing dentists, determine the practice privileges of the dentists retained by Provider, perform quality assurance, utilization review, and Provider profiling functions, and otherwise resolve dental competency issues. The dental peer review committee shall function pursuant to formal written policies and procedures established by Provider upon consultation with and the assistance of Service Company. (b) Provider also shall adopt a quality assurance program to monitor and evaluate the quality and cost-effectiveness of the Dental Care provided by the dentist personnel of Provider Provider’s dentists and other by non-dentist personnel providing Dental Care under the supervision of Provider's ’s dentists. Upon request of Provider, Service Company shall provide administrative assistance to Provider in performing its quality assurance activities. All costs and expenses incurred in connection with this Section 5.5(b) shall be deemed Clinic Expenses. (c) Provider shall cooperate fully with Service Company in an effort to achieve and maintain full accreditation status for Provider. For purposes of facilitating accreditation and Provider with AAAHC or such other related processes and without limiting Provider's responsibilities under the preceding sentence, Provider shall develop and maintain a philosophy of practice and a set of practice guidelines which are acceptable to the Policy Board. Provider shall cause all personnel retained by it to abide by such philosophy and guidelines at all timesaccrediting body as Service Company may reasonably designate. (d) Provider shall, at the direction of the Policy Board, shall support the developmentRisk Management Procedures implemented pursuant to this Agreement or otherwise agreed upon by the Parties, maintenancetake all actions related to such Risk Management Procedures as may be reasonably requested by Service Company, and operation of a patient concerns and claims recording, reporting, review, resolution, and tracking process which is acceptable to the Policy Board. Provider shall cause all personnel retained by it to comply fully with such process at all times. Without limiting the preceding sentence: (i) Provider shall reasonably cooperate in the risk management program and practices operated by Parent from time to time; and (ii) if, at any time, Service Company reasonably determines that any of Provider’s dentists or other personnel is or is likely to be engaging in any activity that presents a material risk to the health or safety of patients, Service Company’s employees, or others, may create unacceptable legal risks to Service Company, or is otherwise inconsistent with the Risk Management Procedures or Parent’s risk management program, Service Company shall have the right to request that Provider cause that activity to be terminated, and Provider shall comply with that request. In addition, Service Company shall not be obligated to provide Services in support of any such activity. (e) Provider shall, with the assistance of Service Company, develop a set of quality standards and utilization, process monitoring, and reporting guidelines. Provider shall cause all personnel retained by it to comply with such standards and guidelines. (f) Provider shall, with the assistance of Service Company, develop patient grievance procedures to the extent not specifically addressed in this Agreement. Provider shall cause all personnel retained by it to comply with such procedures.

Peer Review and Quality Assurance. Provider shall conduct its peer --------------------------------- review and quality assurance activities in a manner that is consistent with maintaining the confidentiality of the related processes, actions, and documentation. (a) Provider shall designate a committee of dentists to function as a dental peer review committee to review credentials of potential dentist recruits, periodically review the credentials of Provider's ’s existing dentists, determine the practice privileges of the dentists retained by Provider, perform quality assurance, utilization review, and Provider profiling functions, and otherwise resolve dental competency issues. The dental peer review committee shall function pursuant to formal written policies and procedures established by Provider upon consultation with and the assistance of Service Company. (b) Provider also shall adopt a quality assurance program to monitor and evaluate the quality and cost-effectiveness of the Dental Care provided by the dentist personnel of Provider Provider’s dentists and other by non-dentist personnel providing Dental Care under the supervision of Provider's ’s dentists. Upon request of Provider, Service Company shall provide administrative assistance to Provider in performing its quality assurance activities. All costs and expenses incurred in connection with this Section 5.5(b) shall be deemed Clinic Expenses. (c) Provider shall cooperate fully with Service Company in an effort to achieve and maintain full accreditation status for Provider. For purposes of facilitating accreditation and other related processes and without limiting Provider's ’s responsibilities under the preceding sentence, Provider shall develop and maintain a philosophy of practice and a set of practice guidelines which are reasonably acceptable to the Policy Board. Provider shall cause all personnel retained by it to abide by such philosophy and guidelines at all times. (d) Provider shall, at the direction of the Policy Board, shall support the development, maintenancerisk management procedures implemented pursuant to this Agreement, and operation of a patient concerns and claims recording, reporting, review, resolution, and tracking process which is acceptable shall take all actions related to the Policy Boardsuch risk management procedures as may be reasonably requested by Service Company. Provider shall cause all personnel retained by it to comply fully with such process at all times. (e) Provider shall, with the assistance of Service Company, develop a set of quality standards and utilization, process monitoring, and reporting guidelines. Provider shall cause all personnel retained by it to comply with such standards and guidelines. (f) Provider shall, with the assistance of Service Company, develop patient grievance procedures to the extent not specifically addressed in this Agreement. Provider shall cause all personnel retained by it to comply with such procedures.

Peer Review and Quality Assurance. Provider shall conduct its peer --------------------------------- review and quality assurance activities in a manner that is consistent with maintaining the confidentiality of the related processes, actions, and documentation. (a) Provider shall designate a committee of dentists to function as a dental peer review committee to review credentials of potential dentist recruits, periodically review the credentials of Provider's ’s existing dentists, determine the practice privileges of the dentists retained by Provider, perform quality assurance, utilization review, and Provider profiling functions, and otherwise resolve dental competency issues. The dental peer review committee shall function pursuant to formal written policies and procedures established by Provider upon consultation with and the assistance of Service Company. (b) Provider also shall adopt a quality assurance program to monitor and evaluate the quality and cost-effectiveness of the Dental Care provided by the dentist personnel of Provider Provider’s dentists and other by non-dentist personnel providing Dental Care under the supervision of Provider's ’s dentists. Upon request of Provider, Service Company shall provide administrative assistance to Provider in performing its quality assurance activities. All costs and expenses incurred in connection with this Section 5.5(b) shall be deemed Clinic Expenses. (c) Provider shall cooperate fully with Service Company in an effort to achieve and maintain full accreditation status for Provider. For purposes of facilitating accreditation and Provider with AAAHC or such other related processes and without limiting Provider's responsibilities under the preceding sentence, Provider shall develop and maintain a philosophy of practice and a set of practice guidelines which are acceptable to the Policy Boardaccrediting body as Service Company may reasonably designate. Provider shall cause all personnel retained by it to abide by such philosophy and guidelines at all times. (d) Provider shall, at the direction of the Policy Board, support the developmentRisk Management Procedures implemented pursuant to this Agreement or otherwise agreed upon by the Parties, maintenancetake all actions related to such Risk Management Procedures as may be reasonably requested by Service Company, and operation of a patient concerns and claims recording, reporting, review, resolution, and tracking process which is acceptable to the Policy Board. Provider shall cause all personnel retained by it to comply fully with such process at all times. Without limiting the preceding sentence: (i) Provider shall reasonably cooperate in the risk management program and practices operated by Parent from time to time; and (ii) if, at any time, Service Company reasonably determines that any of Provider’s dentists or other personnel is or is likely to be engaging in any activity that presents a material risk to the health or safety of patients, Service Company’s employees, or others, may create unacceptable legal risks to Service Company, or is otherwise inconsistent with the Risk Management Procedures or Parent’s risk management program, Service Company shall have the right to request that Provider cause that activity to be terminated, and Provider shall comply with that request. In addition, Service Company shall not be obligated to provide Services in support of any such activity. (ed) Provider shall, with the assistance of Service Company, develop a set of quality standards and utilization, process monitoring, and reporting guidelines. Provider shall cause all personnel retained by it to comply with such standards and guidelines. (f) Provider shall, with the assistance of Service Company, develop patient grievance procedures to the extent not specifically addressed in this Agreement. Provider shall cause all personnel retained by it to comply with such procedures.

Peer Review and Quality Assurance. Provider shall conduct --------------------------------- its peer --------------------------------- review and quality assurance activities in a manner that is consistent with maintaining the confidentiality of the related processes, actions, and documentation. (a) Provider shall designate a committee of dentists to function as a dental peer review committee to review credentials of potential dentist recruits, periodically review the credentials of Provider's existing dentists, determine the practice privileges of the dentists retained by Provider, perform quality assurance, utilization review, and Provider profiling functions, and otherwise resolve dental competency issues. The dental peer review committee shall function pursuant to formal written policies and procedures established by Provider upon consultation with and the assistance of Service Company. (b) Provider also shall adopt a quality assurance program to monitor and evaluate the quality and cost-effectiveness of the Dental Care provided by the dentist personnel of Provider and other non-dentist personnel providing Dental Care under the supervision of Provider's dentists. Upon request of Provider, Service Company shall provide administrative assistance to Provider in performing its quality assurance activities. (c) Provider shall cooperate fully with Service Company in an effort to achieve and maintain full accreditation status for Provider. For purposes of facilitating accreditation and other related processes and without limiting Provider's responsibilities under the preceding sentence, Provider shall develop and maintain a philosophy of practice and a set of practice guidelines which are acceptable to the Policy Board. Provider shall cause all personnel retained by it to abide by such philosophy and guidelines at all times. (d) Provider shall, at the direction of the Policy Board, support the development, maintenance, and operation of a patient concerns and claims recording, reporting, review, resolution, and tracking process which is acceptable to the Policy Board. Provider shall cause all personnel retained by it to comply fully with such process at all times. (e) Provider shall, with the assistance of Service Company, develop a set of quality standards and utilization, process monitoring, and reporting guidelines. Provider shall cause all personnel retained by it to comply with such standards and guidelines.

Peer Review and Quality Assurance. Provider shall conduct --------------------------------- its peer --------------------------------- review and quality assurance activities in a manner that is consistent with maintaining the confidentiality of the related processes, actions, and documentation. (a) Provider shall designate a committee of dentists to function as a dental peer review committee to review credentials of potential dentist recruits, periodically review the credentials of Provider's existing dentists, determine the practice privileges of the dentists retained by Provider, perform quality assurance, utilization review, and Provider profiling functions, and otherwise resolve dental competency issues. The dental peer review committee shall function pursuant to formal written policies and procedures established by Provider upon consultation with and the assistance of Service Company. (b) Provider also shall adopt a quality assurance program to monitor and evaluate the quality and cost-effectiveness of the Dental Care provided by the dentist personnel of Provider and other non-dentist personnel providing Dental Care under the supervision of Provider's dentists. Upon request of Provider, Service Company shall provide administrative assistance to Provider in performing its quality assurance activities. (c) Provider shall cooperate fully with Service Company in an effort to achieve and maintain full accreditation status for Provider. For purposes of facilitating accreditation and other related processes and without limiting Provider's responsibilities under the preceding sentence, Provider shall develop and maintain a philosophy of practice and a set of practice guidelines which are acceptable to the Policy Board. Provider shall cause all personnel retained by it to abide by such philosophy and guidelines at all times. (d) Provider shall, at after consultation with Service Company and consideration of the direction recommendations of the Policy Board, support the development, maintenance, and operation of a patient concerns and claims recording, reporting, review, resolution, and tracking process which is acceptable to meets the Policy Boardquality standards of Service Company. Provider shall cause all personnel retained by it to comply fully with such process at all times. (e) Provider shall, with the assistance of Service Company, develop a set of quality standards and utilization, process monitoring, and reporting guidelines. Provider shall cause all personnel retained by it to comply with such standards and guidelines.

Peer Review and Quality Assurance. Provider shall conduct its peer --------------------------------- review and quality assurance activities in a manner that is consistent with maintaining the confidentiality of the related processes, actions, and documentation. (a) Provider shall designate a committee of dentists to function as a dental peer review committee to review credentials of potential dentist recruits, periodically review the credentials of Provider's ’s existing dentists, determine the practice privileges of the dentists retained by Provider, perform quality assurance, utilization review, and Provider profiling functions, and otherwise resolve dental competency issues. The dental peer review committee shall function pursuant to formal written policies and procedures established by Provider upon consultation with and the assistance of Service Company. (b) Provider also shall adopt a quality assurance program to monitor and evaluate the quality and cost-effectiveness of the Dental Care provided by the dentist personnel of Provider and other non-dentist personnel providing Dental Care under the supervision of Provider's ’s dentists. Upon request of Provider, Service Company shall provide administrative assistance to Provider in performing its quality assurance activities. (c) Provider shall cooperate fully with Service Company in an effort to achieve and maintain full accreditation status for Provider. For purposes of facilitating accreditation and other related processes and without limiting Provider's ’s responsibilities under the preceding sentence, Provider shall develop and maintain a philosophy of practice and a set of practice guidelines which are acceptable to the Policy Board. Provider shall cause all personnel retained by it to abide by such philosophy and guidelines at all times. (d) Provider shall, at after consultation with Service Company and consideration of the direction recommendations of the Policy Board, support the development, maintenance, and operation of a patient concerns and claims recording, reporting, review, resolution, and tracking process which is acceptable to meets the Policy Boardquality standards of Service Company. Provider shall cause all personnel retained by it to comply fully with such process at all times. (e) Provider shall, with the assistance of Service Company, develop a set of quality standards and utilization, process monitoring, and reporting guidelines. Provider shall cause all personnel retained by it to comply with such standards and guidelines.