HEDIS® 2018 Commercial Results Are In
Each year our goal is to improve our process for requesting and obtaining medical records for our HEDIS project. In order to demonstrate the exceptional care that you have provided to our members and in an effort to improve our scores, you and your office staff can help facilitate the HEDIS process improvement by:
- Responding to our requests for medical records within five days, if possible
- Providing the appropriate care within the designated timeframes
- Accurately coding all claims
- Documenting all care clearly in the patient’s medical record
Further information regarding documentation guidelines and administrative codes can be found on the HEDIS page of our Provider Portal. In addition more information on HEDIS can be found by visiting the provider portal at: www.anthem.com > Provider > Choose State > Find Resources > Health & Wellness (top blue bar) > Quality Improvement and Standards > HEDIS Information. You will find reference documents entitled “HEDIS 101 for Providers” and “HEDIS Physician Documentation Guidelines and Administrative Codes”.
The following table shows some of our key measure rates across Colorodo.
- Yellow boxes indicate rates that are above the national average.
- Bold indicates improvement in rate over the previous year.
- B/R = Biased Rate
- Comprehensive Diabetes Care - Poor HbA1c Control (>9): Lower rate is good
HEDIS 2018 COMMERCIAL COLORODO HMO & PPO results
Now is the time to review your patient’s records to ensure that they have received their preventative care and/or immunizations before the end of the year.
Again, we thank you and your staff for demonstrating teamwork as we work together to improve the health of our members and your patients. We look forward to working with you again next HEDIS season.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)
December 2018 Anthem Provider Newsletter - CO