Quality First Medical Centers, Inc. is a co-operative network of medical providers
that integrates all aspects of the Workers Compensation process by bringing together the Insurance companies, TPA's, employers, providers and patients. Unlike PPO Network's Quality First does not discount any provider fees. Our goal is to work with physicians to increase their patient flow and decrease expenses thus increasing your bottom-line profits.
Quality First is a national cooperative for healthcare professionals providing the power
and services necessary to allow members to succeed in their respective market place and to become more profitable while increasing the quality of their delivery.
The core service provided by Quality First is National Marketing of your practice as part of our network of occupational medical providers.
As more and more corporations choose the Quality First as their recommended providers, you will see an increase in the number of new workers compensation patients. Because we are not a PPO each provider receives an exclusive based on your specialty. The unique co branding of Quality First with your clinic truly minimizes any financial risk.
As the market place continues to get smaller a competitive edge is needed
and we believe the answer is becoming a Quality First affiliate. We hope you feel the same and join our team.
Clearinghouse
AEGEAN is the industry leading EDI clearinghouse, uniting providers and payors in the Workers’ Compensation and Automobile insurance industry. We use a secure FTP interface which allows providers to upload their workers’ comp and automobile claims electronically to participating payors directly from our website. Our clearinghouse will accelerate the conversion of claims to cash flow, amplify operational efficiency, and lower the total cost of bill processing.
Your Clearinghouse Solution
The AEGEAN clearinghouse provides crucial electronic connectivity between medical providers, workers’ compensation and auto payors.
Our integrated bill processing solution and secondary scrubbing of bills facilitates easy electronic attachment of required supporting documentation which results in faster acceptance of claims and prompt payments. Prompt claim resolution has a positive impact for all parties because the sooner the bill is accepted by the payor, the sooner it can be worked. On average the turnaround for payment is 10 days faster than printing and mailing claims. The AEGEAN management team understands the bill review process for workers’ comp and auto payors; our technology facilitates an efficient and secure provider-to-payor relationship in a completely paperless atmosphere. As the regulatory environment changes and the industry continues to evolve, AEGEAN will continue to transform the document processing platform and bill analysis systems to ensure compliance and utilization of the latest technology requirements.
Key Features
Low clearinghouse fees - Lowest per-bill fees to submit to any participating workers’ comp and automobile insurance carriers in the US
No added fees for mandatory supporting documentation
Use existing billing software to submit bills
Our secure FTP software allows you to continue to utilize your existing practice management software to submit bills and supporting documentation.
We understand the requirements of workers' compensation and auto med pay payors; attachments are always sent with bills.
Each practice designates their own file naming convention to ensure that bills and notes are matched properly.
Know the date and time your bills were submitted and, if necessary, when resubmissions were made
How it Works
AEGEAN accepts your bills a standard 837 EDI format.
The bills and all corresponding documentation are matched by using a unique identifier. This identifier is determined specifically for your practice.
The AEGEAN software then verifies the information on your claim files to ensure the claim is complete.
Claims are then submitted directly to the various payors.
Becoming an Affiliate Clinic
Steps to Becoming a Quality First Affiliate
Becoming a Quality First Medical Centers Inc. affiliate, involves several step.
Step One
Have a commitment to providing the best available medical care.
Step Two
A willingness to implement changes which considers all the stakeholders (Patient, Employer, Claims Administrator and other affiliates).
Step Three
A desire to put the results up against your peers.
Step Four
Willing to do cost shifting to provide support of ongoing to the cooperative.
Step Five
Willing to grow your practice.
Step Six
Willing to co-brand your practice with Quality First.
National Sales & Marketing
Try to imagine the expense and complexity of hiring even one person to market your services nationwide.
Salary, employee benefits, incentives, travel and entertainment expenses combine to make it an expensive undertaking. Simply identifying, recruiting and supporting a person is a daunting task. Add to that the daily management of a national sales representative, and you have a significant distraction from the practice of medicine. Very few medical professionals can justify or absorb these expenses. The solution is cooperative purchasing.
Our national marketing professionals have over 80 years of combined insurance industry and medical experience.
Our representatives understand the workers compensation and group medical claims process
because we have lived it and managed it throughout our careers.
We enjoy longstanding relationships with insurance companies
third-party administrators, nurse case managers, consulting companies, and insurance brokers nationally. This industry experience allows our marketing team to work side-by-side with the people who influence the selection of treating providers and all related industrial medical services.
Quality First also understands what Claims and Utilization Management firms seek from treating physicians.
We continue to build our company around finding the finest providers and sharing our industry knowledge with the primary goal making the whole greater than the sum of its parts. We passionately and professionally communicate to payors what makes our physicians the right choice for the treatment of their employees. If patient care, cost and results are important then becoming a member of Quality First® is the right choice.
Local Sales & Marketing
The Quality First Local Sales and Marketing Cooperative has addressed the needs of medical providers
who cannot justify the cost of hiring a full-time sales representative. This benefit enables providers to split the cost of a full-time representative between a maximum of four facilities. Our cost sharing methodology allows providers to attract top performers and purchase only the amount of services desired. The program empowers you to decide how many days are needed for your practice and pay only the pro rata share of the salary, benefits and profits. For each day purchased you receive one fifth of the time of that dedicated professional.
The local representative will get to know your facility and the services provided.
In addition he or she will spend time understanding the community you serve. Co-branding your facility with Quality First®, your dedicated representative will develop relationships with employers and other organizations. You will be highlighted as the premier provider in the agreed upon territory. To ensure the fairness of the shared marketing and sales initiative, each representative works with a maximum of four facilities.
We urge you to consider joining your peers and begin to see how approaching sales and marketing as a team divides the cost and multiplies the benefit.
DME's/Supplies
The supplies, durable medical equipment and all other equipment you need - At the time you need them, At the cost you want.
Quality First® has negotiated pricing generally reserved for large practices and other institutions.
As an affiliate, you have the ability to order whatever you need, drop shipped directly to your door.
The Quality First® group purchasing website is the physician's source for solutions that improve practice performance and reduce time spent on administrative tasks,
allowing doctors to spend more time with patients.
If there is something new you need since you last updated your formulary just call your account manager and we will get a price for you to compare.
Office Depot Affiliate Program
All Quality First Members recieve special discounts through our office depot partnership program. These include, in-store and online purchases. Some Benefits of the program include:
Up to 30% off Everyday low retail price on ‘Core List’
Up to 15% off Everyday low retail price on our Top 10 Selling Papers
Up to 15% off Everyday low retail price on our Top 40 Inks & Toners
5% off Everyday low retail price on almost everything Office Depot sells (some exclusions apply)
Special Pricing on Copy & Print
$2.50 Black & White copies
$0.29 Color Copies
40% off finishing-including laminating, binding, vinyl banners, paper upgrades etc.
Save 10-60% off on over 150 Cleaning and Break room supplies
Additional special offers and incentives
Free Next Day Delivery for Online Purchases of $50 or more
Dedicated Account Manager
Store Purchasing Card, so you get the same discounts in-store
Payor Support
Quality First Medical Centers Inc. built the Aegean system with the sole purpose of saving valuable time for all parties involved in the workers' compensation process.
The goal is to speed up communication and improve the flow of information which means, Aegean becomes your communication facilitator for all Quality First Providers. To find out how much time and resources the Aegean™ system can save you and your case management team, try our cost savings calculator.
The HIPAA compliant electronic exchange of information is sent encrypted
and allows for the receipt of all documents associated with each injured worker including progress notes, bills, work status forms, prescriptions, and more.
Although there is no cost for this service, we require your organization to provide a liaison that will be given administrative rights.
Benefits
Aegean brings efficiencies to employers, third party administrators, and insurance companies through a convenient online request system. We dramatically improve stakeholders’ time spent gathering information by providing the following benefits:
Experienced team responding to your requests
24/7/365 online access
Calls are answered by live representatives (during normal business hours)
Medical Record Access (including progress notes, work status and all other reports associated with the patients’ workers compensation claim)
Ability to connect you with the treating provider via a telephone conference when warranted to get your questions answered
Assistance in scheduling patients with quality providers of appropriate speciality
Provider Support
Quality First Medical Centers Inc. built the Aegean Help Desk with the sole purpose of saving valuable time for all parties involved with workers compensation matters.
The goal is to speed up communication and the flow of information which means, Aegean becomes your communication facilitator.
The HIPAA compliant electronic exchange of information is sent encrypted and allows for the attachment of all documents associated with each injured worker.
Aegean brings efficiencies to your clinic through our Help Desk Ticketing System. We improve front and back office functions allowing you and your staff to provide greater focus on patient care. Aegean ensures all necessary information is channeled to the appropriate parties pertaining to each patient.
Benefits
At a minimal per click charge, all Quality First affiliates receive the following benefits:
Insurance Company authorization for diagnostic testing, Physical Therapy, referrals to specialists, surgery and/or other procedures
Updates on requests within 48 hours
Online and telephonic access to Aegean Ticketing System (24/7/365 online access)
Centralized Scheduling
Quality First Medical Centers, Inc. understands efficiency, convenience, and saving time is critical at the time of an accident.
We take the pain out of finding physicians for your injured workers.
Benefits
The benefits of centralized scheduling include:
One phone number for all appointment requests
Same day of injury appointments provided whenever possible
Walk-in appointments available at select locations
All other initial appointments scheduled within 24 hours of request
Convenient locations
Billing & Collections
Why outsource your billing to Quality First:
Twenty-five percent (25%) of all medical practice income is lost due to Under Pricing, Missed Charges or Un-reimbursed claims
Our commitment to becoming a green organization means
the claims (when possible) are submitted electronically reducing processing time and accelerating the reimbursement process.
Our constant monitoring of each insurance company’s claim processing rules ensures timely and higher reimbursements for our providers
Eliminates staffing concerns
Frees staff to attend to other critical functions
Health Information Technology (HIT)
Quality First Medical Centers can help your practice determine areas of improvement to increase revenue, productivity and optimize workflow. Some of the services provided are listed below. If you have a specific need, not listed, please contact us at 1-877-QFMCTRS (736-2877).
Project planning and management for Electronic Medical Record (EMR) implementation
Vendor neutral EMR selection based on individual practice criteria
Practice readiness and workflow analysis identifying bottlenecks or problem areas
Choose the best implementation strategy and data conversion plan
Assist in system setup and testing
Assist in creating a change management plan for both staff and patients
Outcomes Reporting to Employers
PAYER.
The Quality First approach to risk management reporting affords the payor with business tools measuring the results of the medical services provided.
We pride ourselves in our ability to provide reports that allow you to measure total claim outcomes. In addition to standard reports, our IT staff has the ability to customize reports to meet your specific needs.
Elements
Since we understand the full costs associated with patient treatment, standard reports include some of the following elements:
Detailed medical expense and costs associated with treatment
Specific lead services provided
Tracking of time spent in medical care
Average disability duration by provider, injury type and associated co-morbidities
Average time spent in waiting room and clinic
Pharmaceutical and durable medical equipment (DME) usage
No show and cancellation rates
Quality First PPP
Quality First Medical Centers Inc. PPP (Preferred Provider Program) With the final ruling of HB 1698 on March 4th 2013, Illinois employers gained the ability to employ a Preferred Provider Program (PPP) to direct their injured workers to participating providers for treatment.
Quality First was one of the first PPP administrators approved by the State of Illinois
The main value of the WC PPPs is your ability to affirmatively direct medical care in IL WC for the first time
For major IL employers the savings will be significant and immediately measurable
By offering the IL WC PPP, employers cut their employees’ choice of care from two physicians and two chains-of-referral to one doctor, one chain of referral
The Quality First Difference
We are not just another PPO, our providers have proven experience treating workers' compensation patients.
Our system allows for authorized parties to access medical records online from a centralized location
drastically reducing the time spent on the phone to retrieve records from each individual provider's office.
Our centralized scheduling department helps employees in the field to find a participating provider close to their home or work place.
We require our providers to schedule appointments within 24 hours
and submit medical records to our virtual medical practice within 48 hours of the patient's visit.
Our dedicated support staff is here to assist employers and payors with any questions or concerns.
Frequently Asked Questions
What is a PPP?
A PPP (Preferred Provider Panel) is a state-wide network of physicians that provide occupational injury care. The panel includes physicians from all specialty groups. A PPP administrator is responsible for selecting the physicians in the network. The State of Illinois Department of Insurance approves all PPP administrators. Quality First Medical Centers, Inc. was one of the first PPP administrators approved by the State of Illinois.
What changes when I choose a PPP?
Your PPP will assist you in notifying all employees of your selection. All employees must read and sign the PPP notice. When an injury occurs on the job, employees should seek treatment from providers within the PPP network. If the injured worker wishes to see a provider outside of the PPP, they must notify the employer in writing. The employee can then choose their own physician outside the PPP network. After the employee has exhausted their two choices, the employer may not be liable for medical expenses. Employees have the choice to opt out of the program entirely, but must notify the employer in writing of their choice to do so.
What if the employee needs emergency treatment?
The number of provider choices does not include initial emergency treatment. The employer should follow up with a PPP physician after emergency treatment. PPPs like Quality First also include emergency facilities on their listing of approved providers.
What if I have a problem with a PPP provider?
Contact your PPP administrator. The PPP administrator will help you resolve any issues you may have with a PPP provider. You may also nominate a provider for inclusion in the PPP by contacting the PPP administrator.
How do I implement a PPP for my organization?
First, you must select a PPP network that meets your specific needs. A list of approved PPP administrators can be found here. Your PPP will work with you to implement the program. All employees must be notified of your PPP election. Quality First has tools to help you notify your employees.
I’m interested in the Quality First PPP. Who should I contact?
As your PPP administrator, we will guide you through the process of implementing the PPP program as an Illinois employer or insurance carrier. We offer other services such as centralized scheduling, and a centralized medical records department for sharing electronic records with authorized users. Contact Sandi Torres at stores@qfmc.com or call (312)960-6205 extension 328 for more information. As your PPP, Quality First also provides you with centralized scheduling and online medical records access. We are committed to providing your employees with the highest quality care as our standard.
Wellness and Preventative Services
Pre-Placement Services
Each employer has unique pre-employment screening requirements. Quality First will put together a customized plan that fits the individual needs of every employer. Our services include medical exams, drug testing, alcohol screening, and medical questionnaires We provide comprehensive pre-screening services that are designed to fit the needs of each employer based on employer regulations, rules and job requirements. Our customized employer services will enable employers to reduce workers’ compensation and disability costs.
Drug And Alcohol Testing
As concerns regarding job safety and work productivity are rising, Quality First works with employers to maintain a drug and alcohol free healthy workplace environment. Our drug and alcohol testing programs are customized to fit your needs, whether you need testing for regulatory compliance, random drug/alcohol testing, or pre-employment testing. We understand and respect the privacy factor involved with drug and alcohol testing and have certified medical staff to evaluate the results. Our drug and alcohol services include substance abuse prevention as well as education. We also work with employers to facilitate procedures and training, writing policies, as well as training staff on how to educate their employees on substance abuse policies. Quality First will handle all aspects related to drug and alcohol testing to ensure that your workplace is conducive to a safe and healthy environment.
Education
Quality First will provide Employee Assistance Programs which will include assessments, counseling, referral services, crisis intervention, customized educational seminars and training based on your needs, and work-life balance programs.
Work Life Balance Programs
Prenatal
Child Care Training
Day Camp
Adult Care Programs
Elder Care Programs
Lunch and Learn Sessions
Health Talks on Various Topics
Ergonomics Assessments
Tobacco Cessation Programs
Exercise Programs
Hypertension
Industrial Hygiene
Housing Options
Special Needs Support Programs
Job Training Resources
Personal Development Resources
Legal Services
Discount Programs
Customized Additional Programs Per Request
Mobile Clinic & Services
Quality First will provide a 37 sq. ft. mobile clinic that is able to provide injury care services when needed. The mobile clinic has 2 exam rooms, a waiting area, a handicap accessible ramp, and staff on-site to provide convenient healthcare for your employees. We will not be able to provide X-rays at our Mobile clinic, however, will be able to refer you to a Quality First affiliate for X-Rays.
On-Site Physicals
Physical Therapy
Audiograms for Detecting Hearing Loss
Drug Testing
Respiratory Physicals to check lungs
Pulmonary Exams
Injury Care
Patient Services
If you have been injured on the job, Quality First provides customized treatment options depending on your individual needs and injury.
We incorporate both patient treatment and education to treat and prevent injuries. Our goal is to get your quality of life back to normal as soon as possible so you can return to your normal routine. At Quality First, we are dedicated to your health and wellness; we understand the impact an injury can have on your everyday life. Quality First programs were designed with our primary goal: to get you on the road to a speedy recovery so you can return to work.
Quality First offers many services for Patients
Injury Treatment Programs, Wellness Programs, and additional resources to aid in your health & well-being. We also welcome patient feedback and are always looking for ways to serve you better. We pride ourselves on staying one step ahead of everyone else in the industry so that we can provide you with the most modern treatments and wellness programs. Quality First has an extensive network of physicians in your area; please visit our Quality First Locations page to find a physician in your area that fits your individual healthcare needs. Our providers are professionals in Occupational Medicine. Our facilities across the nation are comprehensive health centers and some are even provide mobile health services.
Quality First Injury Treatment Programs
FAA Physicals
HAZMAT Physicals
DOT Physicals
Drug Testing Services (NIDA and non NIDA) and Breath Alcohol Testing
Immediate Treatment Program for Work-Related Injuries
Vaccinations
Foreign Travel Vaccines
Return to Work/Fitness for Duty Evaluations (for work- and non-work-related injuries)
Psychological Evaluation (assists in coping with a work injury)
Family Medical Leave Forms
Disability Forms
Substance Abuse Evaluations
On Site Drug Testing
Need On-Site, On Demand Drug Testing?
Quality First offers on-site after hours drug testing for all member providers. Simply call the scheduling desk and you will be directed to our service provider that can send out a technician anywhere within the Chicagoland area to your location or an employer's site. We also have a mobile clinic to provide on site drug testing and workplace physicals for larger groups. Contact Sandi Torres for more information at storres@qfmc.com.
Occupational Medicine
Quality First offers:
DOT physicals
Hazmat physicals
Pre-employment and post accident physicals
Drug (NIDA and non-NIDA) and Breath Alcohol testing
Injury management services
Immunizations
Return to work, fitness for duty and second opinion exams
Respiratory compliance
Work site safety and ergonomic programs
Work site wellness programs
Family Medical Leave forms
Long and short term disability forms
Orthopedic
Quality First treats the following orthopedic ailments:
General Orthopedics
We treat musculoskeletal trauma, sports injuries, degenerative diseases, infections, tumors, and congenital conditions.
Hand Surgery
Hand Surgery can treat diseases that cause pain and weaken the strength, function and flexibility of your wrist and fingers. Hand Surgery can restore to near normal the function of fingers and hands injured by trauma. Surgery can also correct abnormalities that were present at birth.
Shoulder & Elbow Surgery
Surgery for shoulder & elbow injuries from accidents, falls & on the job injuries.
Arthroplasty (Total Joint Reconstruction)
Arthroplasty is the reconstruction or reshaping of a damaged or diseased joint. This surgery most often involves joint replacement, the implantation of an artificial joint (prosthesis).
Foot & Ankle Surgery
Surgery performed to aid in foot & ankle problems.
Spine Surgery
Minimally invasive spine surgery and microsurgery.
Surgical Sports Medicine
Sports injuries that require surgical procedures and treat common soft tissue injuries of the upper and lower extremities.
Orthopedic Second Opinions
If you are unsure or have doubts, questions about your condition, we are here to provide you with a second opinion.
Diagnostic X-Rays
we offer diagnostic X-Rays.
Neurology
Our Quality First Medical Center Neurologists diagnose and treat the following conditions:
Carpal tunnel syndrome
Cubital tunnel syndrome
Ulnar nerve dysfunction
Multiple sclerosis
Epilepsy (seizures)
Headaches
Dementia, including Alzheimer's disease
Multiple sclerosis
Parkinson's disease and other movement disorders
Sleep disorders
Various forms of pain
Pain Management
Chronic pain often results from conditions that are difficult to diagnose and treat, and that may take a long time to reverse. Some examples include cancer, neuropathy, and referred pain. Often, pain pathways are set up that continue to transmit the sensation of pain even though the underlying condition or injury that originally caused pain has been healed. In such situations, the pain itself is frequently managed separately from the underlying condition of which it is a symptom, or the goal of treatment is to manage the pain with no treatment of any underlying condition (e.g. if the underlying condition has resolved or if no identifiable source of the pain can be found).
Conditions
Quality First Medical Centers treats the following conditions:
Chronic back pain
Disc dengeneration
Herniated disk
Myofascial pain
Spinal stenosis
Failed back syndrome
Sacroiliac joint pain
Facet joint syndrome
Headaches
Complex regional pain syndrome
Treatments
Quality First Medical Centers offers the following treatments:
Epidural steroid injections
Facet joint injections
Sacroiliac joint injections
Discograms
Percutaneous disc decompressions
Spinal cord stimulators
Intrathecal pump implantation
Intradiscal electothermal therapy(IDET)
Radiofrequency Neuroablation
Physical Therapy
Quality First medical Centers provides the following physical therapy services:
Ultrasound
Electrical Stimulation
Moist Heat
Manual Therapy
Work Conditioning
Functional Capacity Evaluations
Spine Stabilization Program
Treadmill
Computerized Mechanical Lumbar and Cervical Traction
Custom orthotics
Massage therapy
Spinal stabilization program
Pre/Post operative rehabilitation program
Wound care program
Sports Medicine injuries
Individual exercise program
Alternative Medicine
Acupuncture Treatments
Acupuncture is a method of preventing, diagnosing & treating many common diseases by inserting metal needles into the body surface of designated locations, called acupuncture points, at various depths and angles. Classical acupuncture involves the insertion and manipulation of filiform acupuncture needles through the skin to specific points on the body for the purpose of regulating life energy in order to achieve therapeutic results.
Chiropractic Pain Management and Manipulation
Chiropractic is a natural preventive and rehabilitative healthcare that concentrates on keeping people well. Doctors of chiropractic attempt to get to the cause of a health problem, rather than just treat the symptoms. The primary focus of chiropractic is the detection, reduction and correction of spinal misalignments called subluxations.
Quality First® offers a full array of medical services solutions to you which assist in the management of your medical expenses with major twists. The over-riding difference in the Quality First® approach is that we have created a marriage between healthcare services delivery and insurance/risk management.