HEDIS 101 for Providers

• HEDIS® helps healthcare providers identify and resolve patient care gaps assigned to their groups.

• As HEDIS® charges go up, providers may receive maximum or additional income.

• Administrative measures use billing / encounter hospitalizations, clinic visits and procedures.

• Hybrid measures are a combination of data obtained from members' medical records and management data.

• The ultimate goal is to send a complaint / encounter code so that the provider will administratively capture all the necessary HEDIS®.

• Do I need to schedule appointments and regular care at the examination room or clinic?

• When talking about starting or stopping prescription, does your doctor or other health care provider ask you the best way?

• In the range 0 to 10, 0 means worst, 10 means best. What are the numbers used to evaluate your doctor?

• How often do your attending physicians listen to you and respect? * This survey has adult version and children's version, the problems are similar *

• If the member complies with the requirement but does not make a claim, please fax the medical record to the member's medical report blank.

• Can not see members by putting them in the office? Please contact our member's outreach department. I can help you

• For HEDIS® Education Conference / Seminar / Webinar and Provider Toolkit, please contact HEDIS® at 1-855-737-0872.

• For other HEDIS® measurement specifications, information, resources, and guidance, please visit the provider's website.

A total of 184 million people participated in the plan to report the results of HEDIS. This makes HEDIS one of the most widely used performance improvement tools in healthcare. HEDIS includes measures for doctors, PPOs and other organizations. Visitors to this page will usually see the HEDIS FAQ, QRS FAQ or ask questions via MyNCQA

Magellan 's 2017 HEDIS (Healthcare Efficacy Data and Information Set) quality indicator series has entered the final stage of data collection. You may have heard the acronym HEDIS - but what does it mean, what does it mean to you? Health care effectiveness data and information set - HEDIS - It was created by the National Quality Assurance Council (NCQA) to measure the clinical quality performance of health plans. This is accomplished by collecting and analyzing data that records clinical care received by individual program members from providers affected by the activities and programs provided by the health plan. Aggregate data and aggregate reports to reflect "collective" or population-based care received by program members. Currently, Magellan has entered the final stage of collection of 2017 HEDIS quality index data.

Planned HEDIS measures are reported annually and represent essential activities of health plans contracted with CMS. Every spring, the person in charge of Pruitt Health Premier is asked to gather a copy of the medical record from the clinic to confirm the HEDIS score. Contact the selected practitioner's office and ask them to assist in collecting these medical records. All records are processed according to the privacy policy of Pruitt Health Premier and subject to the Privacy Policy of Health Insurance Portability and Accountability Act (HIPAA). Only the minimum information necessary for the purpose of this HEDIS program is necessary. HEDIS is regarded as a quality-related healthcare business activity and is permitted by HIPAA's privacy regulations. HEDIS results of Pruitt Health Premier are available upon request