The Healthcare Effectiveness Data and Information Set (HEDIS®) is routinely used to measure and report on health care performance. Healthcare performance review is essential for health care plans to better assess their provider level of service, to recognize any shortfalls in current execution and to make the necessary changes that will help them grow and thrive moving forward.
Health plans that want to acquire accreditation through HEDIS are required to gather data about patient care, organize it into specific measures defined by HEDIS and determine if specific criteria for HEDIS measures have been met. Advantmed’s HEDIS Review process is designed to optimize the time and resources spent on chart review and organize the records and results in a meaningful and effective manner.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Advantmed provides highly targeted and tailored solutions for Medicare Advantage health plans looking to maximize their CMS Five-Star Quality Ratings.
Advantmed’s Five-Star Quality Ratings solutions are customizable and can be augmented by a number of Advantmed services such as HEDIS Abstraction, Record Retrieval, HCC Coding, as well as our Member Outreach programs.
These solutions can be implemented separately or concurrently, depending on the needs of the client.
ACO Quality Review
Advantmed’s ACO Quality Review solution is designed to optimize the time and resources spent on chart review and to organize the records and results in a meaningful and effective manner.
The certified staff at Advantmed routinely performs off-site chart reviews because we feel that keeping valuable personnel in the office, focused on their work allows them to be far more productive than if they were traveling from site to site and abstracting in unproductive provider workspaces. In our experience, this method allows reviewers to provide more accurate and expeditious reviews. We provide annual training to our abstractors and keep them up to date with the technical specifications and rules specific to each project.
Does your staff get interrupted with record requests from patients? Advantmed is prepared to handle that process from beginning to end. Receive a walk-in request from a patient? Simply hand them our card and we will take care of it. This leads to better customer service, enhanced patient satisfaction and increased staff productivity.
With our Release of Information service, your staff can focus on providing quality care to patients.