Nurse Practitioner - Surgery

Peer Review for Quality Management may only be used for improving the quality of health
care or utilization of health care resources in VA medical facilities. Its primary focus is whether
the clinical decisions and actions of a clinician during a specific clinical encounter met the
standard of care.
Provider must have access to their own computer to complete online training, complete written
reviews using MS word software, be able to access VA EMR system to review medical
records, and be able to access Maximus’s secure email system to receive encrypted emails.
Provider has the ability to accept or decline cases; must do so within 24 hrs. Once accepted
the review must be submitted within 3-5 business days, expedited cases are within 24 hours.
Minimum Qualifications:
• Active license
• 20 hours of direct patient care per month
• Board Certification
• MUST have National Provider Identifier (NPI) number
• CANNOT be a VA employee, active duty military, or provide care in military facilities
• 5 years experience in appropriate specialty post training (MD/DO)
• 3 year experience in appropriate specialty post training (non-MD/DO)

Veteran Affairs Clinical Peer Review (VACPR)
Rate Description of Service Completion Time
$100/cs Audit Review 30 min-1 hour
$100/cs Clinical Appeals (rare) 30 min-1 hour
$50/cs Executive Summary Reports 30 min-1 hour
$125/cs Facility-Requested Review 30 min-1 hour
$200/cs Medical Advisory Opinion 2-3 hours
$100/cs Quality Review-Audit Review 30 min-1 hour
$125/cs Quality Review-Facility Requested Review 30 min-1 hour
$125/cs Quality Review-Routine Management Review 30 min-1 hour
$200/cs Quality Review-Medical Advisory Opinion 30 min-1 hour
**Volume of cases vary between 0-10 cases per month, dependent on the types/amounts of
cases received by the VA.**
***Providers will be required to obtain a Personal Identify Verification (PIV) card and
fingerprints, project will support with this requirement.***
If you have any questions please feel free to reach out at your convenience.
Thank you for your support, we look forward to working with you