Making Health Plans More Customer-oriented with HEDIS

by | Published on Feb 7, 2014 | Medical Coding

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HEDIS is an important yardstick by which health plans can measure their performance and worth. In fact, this yardstick is being employed by over 90% of health plans in the US. Results that come with HEDIS data collection act as the measure for quality improvement as well as preventive care. These results transform to HEDIS rates that can evaluate how health plans have managed to show forth their ability to improve in quality measures and preventive care, ultimately benefiting health plan users. HEDIS contains 75 measures dealing with 8 vital care domains.

Care Domains Covered by HEDIS

These care domains include care effectiveness, care access or availability, patient satisfaction of the provided care, stability of the health plan, use of service, care cost, relevant and educated healthcare choices, and clarity and descriptive nature of health plan information.

HEDIS data is reported to the NCQA in the month of June in the reporting year. The data reflects events that have occurred in the measurement calendar year, which is January to December of the previous year.

How a Medical Coding Company Could Help

A reliable medical coding company can offer comprehensive measurement of HEDIS. HEDIS coding services can enable insurers to meet NCQA quality goals. It can also help healthcare practices maximize their HEDIS reimbursement, which will make their plans more attractive to users and prospective customers.

An efficient and experienced medical billing and coding company can offer its comprehensive services for health plans, Medicare Advantage Organizations (MAOs) and physician practices for improving HEDIS scores. HEDIS measurement services could tackle health issues such as the following:

  • Asthma medication use
  • Beta blocker treatment following heart attack
  • Adult BMI Assessment
  • Immunization status
  • Childhood immunizations
  • High blood pressure control
  • Quit smoking advice
  • Antidepressant medication management
  • Older adults care
  • Breast cancer screening
  • Cervical cancer screening
  • Fall risk management
  • Comprehensive diabetes care

With HEDIS you have a great way to improve your health plan performance. For employers, this measure helps to select the right plan for their employees.

Natalie Tornese

Holding a CPC certification from the American Academy of Professional Coders (AAPC), Natalie is a seasoned professional actively managing medical billing, medical coding, verification, and authorization services at OSI.

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