Simpra Advantage Quality

Simpra Advantage (PPO SNP) is designed to meet the needs of our Members and health care partners. In addition, we strive to meet the highest quality and safety standards. We follow standards developed by the National Committee for Quality Assurance (NCQA) to reach this goal.

The Simpra Advantage Quality Improvement (QI) Department has a mission to provide an effective, system-wide, measurable plan for monitoring, evaluating and improving the quality of care and services in a cost-effective and efficient manner to our enrolled Members and contracted providers.

  • Simpra Advantage’s mission, vision, and core values create the foundation for organizational QI.
  • Simpra Advantage uses quality assurance and performance improvement to make decisions and guide our day-to-day operations.
  • Simpra Advantage’s QI Program includes all business lines, partners, departments and services.
  • Simpra Advantage’s QI Program is comprehensive regarding systems of care, management practices, and business practices.
  • Simpra Advantage’s QI Program is data-driven and supports the plan’s mission, vision, and values through continuous improvement and monitoring of medical care, patient safety, behavioral health services, and the delivery of services to Members.
  • Simpra Advantage’s QI Program decisions are based on data, which is collected in a systematic format in alignment with our infrastructure and aggregated in EZCare – Simpra Advantage’s proprietary care management platform.

Quality Objectives

  • To improve the health status of Simpra Advantage Members.
  • To ensure access to high quality and safe health care services in the Simpra Advantage service area.

For more information about the Simpra Advantage Quality program, please call Member Services at 1-844-637-4770 (TTY 711). Calls to this number are free.

Our hours are 8 a.m. to 8 p.m., seven days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holidays) from April 1 through September 30.

Want more information about Simpra Advantage?

Call us at 1-844-637-4770 (TTY: 711).
Our trained member service representatives are available from 8:00 a.m. to 8:00 p.m., or fill out this contact request form to have us call you.

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