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Quality Improvement Program

The purpose of El Paso Health’s Quality Improvement Program is to continuously improve patient safety and Member outcomes by providing well-coordinated care within a robust network of contracted Providers, invested in providing evidence-based care in a patient-centered environment. The Quality Improvement Program is designed to assure that Members receive care that is consistent with our mission.

Our Quality Improvement Program is designed to improve:

  • Quality of care for all physical and behavioral health care and services
  • Member and provider satisfaction
  • Member safety
  • Access to services

As part of our commitment to quality, we review a variety of data to track member complaints, safety concerns, quality outcomes, and member and provider satisfaction in order to improve our programs and services to ensure the best quality care is provided. El Paso Health strives to build relationships that strengthen the delivery of healthcare in our community so that we may be the region’s trusted community health plan.

Commitment to Quality

El Paso Health’s Quality Improvement Program is built upon standards that comply with Texas Department of Insurance (TDI) and HHSC requirements, as applicable. In addition, El Paso Health is accredited by the national accrediting organization URAC and the Quality Improvement Program is consistent with all applicable URAC standards.
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Clinical Practice Guidelines
On an annual basis, El Paso Health reviews and updates our adopted Clinical Practice Guidelines in an effort to promote utilization of the most current evidence-based practice.

Visit our Clinical Practice Guidelines page to view guidelines and learn more.
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You may also contact the Quality Improvement Department at 915-532-3778.
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Access and Availability
In accordance with the Texas Health and Human Services Commission (HHSC) and Texas Department of Insurance (TDI) mandates, El Paso Health must monitor our Providers on an annual basis for 24 hour availability and office accessibility compliance. Your partnership is paramount in the success of our Quality Improvement initiatives and requirements mandated by TDI and HHSC.
Access and Availability Standards
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Quality Measure Tip Sheets
HEDIS ADD Tip SheetInfluenza Vaccine (Flu) Tip SheetTexas Health Steps Medical Checkup Tip SheetSocial Determinants of Health Tip SheetPotentially Preventable Admissions Tip SheetMedical Loss Ratio Tip SheetPotentially Preventable ER Visits Tip SheetAppropriate Antibiotic Use Tip Sheet
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HEDIS Hybrid
HEDIS Medical Record Documentation TipsHEDIS Hybrid FAQHow to send EMR files to EPH
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Texas Health Steps
Texas Health Steps (THSteps) for Providers
1145 Westmoreland Drive
El Paso, TX 79925-5615

Call us at 915-532-3778 STAR/CHIP
Outside El Paso 1-877-532-3778 STAR/CHIP

Call us at 1-833-742-3127 STAR+PLUS

Hours of Operation
8:00 A.M. – 5:00 P.M. MST
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The information posted on this website may be available in other formats such as large print, Braille, and audio. You can request the materials in other formats by calling Member Services at 1-877-532-3778.
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Paper Claim Submissions
El Paso Health - Claims
P.O. Box 971370
El Paso, TX 79997-1370

General Correspondence
P.O. Box 971100
El Paso, TX 79997-1100
You can also report fraud, waste and abuse directly to the Texas Office of Inspector General.
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