Universality of HEDIS
More than 90% of the health plans in the employ HEDIS for measuring their care and service performance. HEDIS basically consists of 80 measures that deal with five care domains. These are measures that are specifically defined so it becomes quite easy to compare health plan performance. The reliability and validity of HEDIS results is ensured by the NCQA-established process that brings in certified auditors to check all the data. Not only do health plans benefit, but employers and consumers also benefit from HEDIS as well. They can use the HEDIS data plus the accreditation information for choosing the health plan that would be right for them.
HEDIS Data Always Updated
The always current nature of HEDIS data is ensured by the NCQA-established process that evolves the measurement set every year. The NCQA has set up the Committee on Performance Measurement which decides on the content for HEDIS including HEDIS measures that need to be included as well as the field tests to determine the measurement.
HEDIS data is well recommended. The respected State of Health Care Quality report offers consumers with the comprehensive HEDIS information. This report provides the full picture of how the nation’s health care system performs. Quality Compass provides HEDIS results for users to compare plans through benchmark information. The many health plan performance reports you find in newspapers and magazines are also based on the HEDIS data. Health plans often report HEDIS data to employers to help the former improve care and service quality.
Elements of HEDIS Coding
HEDIS coding consists of coding reimbursement claims with Current Procedural Terminology (CPT-4) Procedures and International Classification of Diseases and Related Health Problems (ICD-9) Diagnosis Codes. These codes provide the claim as well as encounter information required for payment and care quality goals measurement for NCQA accreditation. Attributing the right and NCQA-approved CPT and ICD-9 codes is important. The claims data must indicate that HEDIS quality was kept as the care goals were achieved.
Efficient HEDIS coding is best offered by a professional medical billing and coding company to health plans. The expert coders have the training and expertise to handle this efficiently. They keep tabs on all the details which ensures precision, a vital factor that determines the NCQA rating for a health plan