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Potential Quality Issue Referral Form Identifying Data Member name: ___ DOB: ___ Member ID #: ___ Provider name: ___ NPI #: ___ Provider address: ___ Phone #: ___ Group×plan: ___ Phone #: ___ PR
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How to fill out potential quality issue referral

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How to fill out potential quality issue referral

01
Gather all necessary information related to the potential quality issue.
02
Identify the specific quality issue and its impact on the product or process.
03
Determine the root cause of the quality issue, if possible.
04
Communicate with relevant stakeholders, such as quality control team or supervisor.
05
Fill out the quality issue referral form with accurate and detailed information.
06
Provide any supporting documents or evidence related to the quality issue.
07
Submit the filled referral form to the appropriate channel or department for review and action.
08
Follow up on the referral to ensure it is being addressed in a timely manner.
09
Participate in any discussions or investigations related to the quality issue, if required.
10
Document and track the resolution of the quality issue for future reference or improvement purposes.

Who needs potential quality issue referral?

01
Anyone who detects or suspects a potential quality issue in a product or process.
02
Quality control personnel responsible for identifying and addressing quality issues.
03
Supervisors or managers overseeing the quality control process.
04
Employees involved in the production or inspection of products.
05
Customers or end-users who experience quality-related problems.
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A potential quality issue referral is a report filed to bring attention to a potential problem with the quality of a product or service.
Anyone who identifies a potential quality issue is required to file a potential quality issue referral.
Potential quality issue referrals can typically be filled out online or submitted through a specific form provided by the organization.
The purpose of a potential quality issue referral is to address and rectify any potential quality issues before they escalate.
Details about the potential issue, any evidence or documentation, and contact information of the person filing the referral.
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