HEDISChart Review
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HEDIS Chart Review

HEDIS (Healthcare Effectiveness Data and Information Set) is a set of standardized performance measures developed by the National Committee for Quality Assurance (NCQA) for the comparing the performance of health plans and driving quality improvement in the market. An established medical billing and coding company, Outsource Strategies International (OSI) provides HEDIS chart review services to help physicians and insurance companies determine if the quality of care measures, as defined by NCQA for the year’s HEDIS audit, have been met.

We have a professional team of experienced AAPC-certified coders who can abstract medical records for HEDIS measures in quick turnaround time. We can scale to accommodate any volume of requests.

Get expert support for your chart review projects – call our toll-free number (800) 670-2809 today!

Detailed Medical Chart Review for HEDIS Compliance

NCQA uses medical chart review as the source of data for the NCQA’s physician recognition program as well as for determining financial rewards or incentives. Health plans that want to obtain NCQA accreditation need to collect data on patient care, organize it into specific measures defined by HEDIS, and verify if specific criteria for these measures have been satisfied. Our comprehensive medical record review (MRR) process is designed to help organizations achieve these goals.

Our HEDIS chart audit ensures that complete and accurate data is collected which reflects the health care services provided. The review helps to measure and evaluate documentation of care as well as the timeliness and quality of service.

We help you meet stringent HEDIS audit rules by providing services for:

  • Collecting data
  • Retrieving medical record of patients included in the review
  • Medical record review for quality control, accuracy and reliability in the HEDIS data
  • Verifying documentation
  • Detailed audit of records
  • Abstraction of relevant data from the medical records
  • Real-time reporting
  • NCQA submission

Adhering to best practices in medical record retrieval, medical coding services and timely submission of claims and encounter data, we simplify the HEDIS medical chart review process, reduce your costs, and enhance your reimbursements. By identifying performance gaps, we help providers make the necessary changes to grow customer satisfaction.