Quality-improvement health-care organization offers help by phone

Stories reporting errors made by health-care providers - including physicians, hospitals, nursing homes and home health agencies - in the course of providing health-care services appear all too often in newspapers and magazines and on Web sites and broadcast news. A patient who receives inadequate or inappropriate care may not know where to go to file a complaint about the treatment received. If Medicare paid for the service, Healthcare Quality Strategies Inc. (HQSI) can conduct a free review of the beneficiary's medical records to determine if the quality of care met or did not meet professionally recognized standards. Getting help is as easy as making a phone call to HQSI at 1-800-624-4557.

HQSI is the federally designated quality-improvement organization for New Jersey. We offer Medicare medical-record review free of charge as part of our health-care quality-improvement contract with the Centers for Medicare and Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services, to ensure the protection of Medicare beneficiaries' health. Examples of a Medicare quality-of-care concern include a beneficiary receiving a medication or treatment that was not ordered; a doctor operating on the wrong part of the body; a patient not being properly evaluated for a problem, such as chest pain, and then not receiving needed treatment; and a beneficiary developing a bedsore [while] in a hospital or nursing home because he was not helped to change his position in the bed or chair.

If a Medicare beneficiary thinks he or she has a quality-of-care concern, [that individual] or his or her designated representative should call HQSI at 1-800-624-4557 to start a medical record review or speak with an HQSI staff member. HQSI also can help the beneficiary complete the paperwork required to begin the review. If the complaint is not related to a health-care quality issue, HQSI will direct the Medicare beneficiary to an appropriate agency that can help.

The purpose of a quality-of-care review is to help health-care professionals and facilities improve the care they provide. Medicare beneficiaries should not be afraid to ask questions about the health care they receive.

Martin P. Margolies

chief executive officer

Healthcare Quality Strategies, Inc.

East Brunswick