What does a HEDIS Compliance Audit review?

A HEDIS Compliance Audit examines whether or not an organization has the capability to process medical, member, and provider information accurately in order to provide automated performance measurement. This includes HEDIS reporting.

A HEDIS Compliance Audit will look at an organization’s:

  • Information practices and control procedures
  • Sampling methods and procedures
  • Data integrity
  • Compliance with HEDIS specs
  • Reporting and documentation