Provider Preventable Conditions

Providers must adhere to the Pennsylvania Department of Public Welfare (DPW) “Provider Preventable Conditions” Bulletin issued in June 2012 և updated in September 2015. Provider Preventable Conditions include but are not limited to:

1. The wrong operation/invasive procedure on correct patient.
2. Operation/invasive procedure on patient not scheduled.
3. The correct operation/invasive procedure on wrong side/body part.

Provider Preventable Conditions involving a Carelon member must be reported to Carelon using Carelon’s Reportable Event form, as well as reported to the Department of Public Welfare using the OPPC Self-Reporting Form.