If you are in the medical field, chances are that you need to be concerned with HEDIS, and more specifically, HEDIS Compliance Audits. Do you know much about HEDIS Compliance Audits? If you don’t, we are here to help. Keep reading to learn more about HEDIS Compliance Audits and how HEDIS Nurses can help with them.
What does a HEDIS Compliance Audit address?
A HEDIS Compliance Audits is designed to look at whether an organization has the capability to process medical, member, and provider information in order to generate accurate performance measures. The HEDIS Compliance Audit looks at information practices, sampling methods, and procedures, data integrity, control procedures, analytic file production, reporting, and documentation. It will also assess the organization’s compliance with HEDIS specifications.
What are the two parts of the HEDIS Compliance Audit?
There are two parts to a HEDIS Compliance Audit. The first is Information System Capabilities. This looks at the organization’s overall IS capabilities for collecting, storing, and reporting health information. The second part of a HEDIS Compliance Audit is HEDIS Specific Standards. During this step, the auditor will look at the information systems and will design the verification audit step for HEDIS measures.
How are audits scored?
A HEDIS Compliance Audit is scored on one of the following outcomes:
- Reportable (rate or count)
- NA (small denominator)
- NB (benefit not offered) (e.g., mental health, chemical dependency)
- NR (not reported)
- NQ (not required to report
- BR (biased rate)
- UN (unaudited)
If you need help analyzing your HEDIS Compliance Audits results, we can help!
Contact HEDIS Nurses today for help with HEDIS Compliance Audits!
Is your company going through a HEDIS Compliance Audit? If so, and you are looking for ways to boost your results, reach out to HEDIS Nurses. Since 0 we have been offering exemplary HEDIS support services. From chart abstractions to full outsourcing of HEDIS projects, we do it all. If you are interested in what our skilled and qualified team of HEDIS Nurses can do, give us a call today at (877) 328-2343 to obtain a quote.
To learn more about the reliable and quality HEDIS and chart abstraction services that we offer, visit us on the web at HEDIS Nurses
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