Peer review services
Improving care through objective peer review.
External peer review provides an independent, objective assessment of clinical care — ensuring credibility, consistency and defensibility in decision-making.
Review types
The right review for the question you need answered.
Comprehensive Physician Peer Review
An in-depth, same-specialty assessment of clinical judgment, quality of care, medical decision-making, documentation and adherence to evidence-based standards.
Focused Physician Peer Review
A targeted evaluation of specific aspects of a provider's practice, initiated by a defined concern, event, complaint or quality indicator.
Ongoing & Focused Professional Practice Evaluation (OPPE / FPPE)
Objective, specialty-specific evaluations that strengthen provider performance programs and help meet HRSA, Joint Commission, CMS and ASC accreditation requirements.
Performance Improvement Review
Analysis that goes beyond the individual provider to find why outcomes occurred and which system factors contributed.
Medical Necessity Review
Independent determinations of whether a treatment, service or level of care is clinically appropriate and consistent with guidelines and coverage criteria.
Medical-Legal Peer Review
Objective evaluations of standard of care, causation and clinical decision-making to support litigation, regulatory and risk management needs.
When is external review necessary?
Particularly valuable when internal review may be insufficient or potentially biased.
Legal concerns
Defensible, evidence-based documentation when a physician's competence or decision-making is questioned in malpractice, liability or regulatory matters.
Clinical ambiguity
Impartial guidance when internal committees or multi-specialty teams reach conflicting conclusions.
Lack of internal expertise
Specialty insight for highly specialized or rare conditions no one on staff can assess.
Conflict of interest
Removes personal, financial or professional relationships from the evaluation.
Limited internal resources
Large-scale reviews completed without diverting staff from operations.
Credibility & validation
Independent verification of internal peer review and quality programs for regulators and payers.
Specialized needs
Expert witnesses for fair hearings, credentialing evaluations, QI initiatives and medical staff appeals.
By providing objective, expert insight, external peer review enables organizations to enhance patient safety, improve care quality, manage risk, and support legally defensible, evidence-based decisions across healthcare, health plans, and legal contexts.
Our process
Four steps from first call to closed case.
- 1
Contact us
Tell us about your case or program. We establish a secure account for confidential, HIPAA-compliant transfer of medical records.
- 2
Review assignment
Your case is assigned to a vetted reviewer with the relevant specialty expertise. A dedicated case manager oversees it from start to finish.
- 3
Secure release
Your final report is delivered through a HIPAA-compliant file transfer system, formatted for clinical, administrative or legal use.
- 4
Completion
You review the report for completeness and clarity. Once it's final and no further action is needed, the case is closed.
Want to discuss your case?
Talk with a case manager
Call (844) 733-7738 or send us a note. We respond within one business day.
Talk to a case manager
Have an urgent case?
Contact us today to discuss how QPS can support your organization. A case manager will respond within 24 hours.