The first part of a HEDIS Compliance Audit is Information System Capabilities. This looks at the organization’s overall information systems capabilities for fathering, storing, and analyzing health information.
Part two of the HEDIS Compliance Audit looks at HEDIS Specific Standards. During this portion of the audit, the auditor reviews the information system and then designs appropriate verification audit steps for various HEDIS measures. This part of the audit addresses compliance with specified reporting practices for several HEDIS domains, including Effectiveness of Care, Access/Availability of Care, Experience of Care, Utilization and Risk-Adjusted Utilization, Health Plan Descriptive Information, and Measures Collected Using Electronic Clinical Data Systems.