HEDIS is a complicated topic matter. There is so much to take into consideration and the measures are changing every year. It might be difficult to get a grip on, but HEDIS is extremely important and it’s essential that you have a good understanding of it. Thankfully, HEDIS Nurses is here to clear the air. In this blog, our experienced team tackles the most frequently asked questions pertaining to HEDIS. Keep reading to learn more!
What is HEDIS coding?
HEDIS stands for the Healthcare Effectiveness Data and Information Set. It is a set of standards utilized by health plans to measure performance in regards to service and quality of care. HEDIS coding is how these services are categorized and standardized across all health plans and geographic locations. Reimbursement claims are coded with CPT and ICD-9. Bills are coded using CPT-4 and ICD-9 codes.
How many HEDIS measures are there?
There are over 90 measures in the Healthcare Effectiveness Data and Information Set. These measures get updated every year by the NCQA. These measures are spread over a variety of “domains of care.” These include Effectiveness of Care, Utilization and Risk-Adjusted Utilization, Experience of Care, Access/Availability of Care, Health Plan Descriptive Information, and Measures Collected Using Electronic Clinical Data Systems.
What are HEDIS star measures?
HEDIS Star Measures is the rating system as it pertains to a health plan’s Medicare Advantage program. These star measures rate how the program performs across a variety of HEDIS quality measures on a five-star scale. If a health plan’s star rating is high enough, they are eligible for financial bonuses.
How do we increase HEDIS rates?
There are many ways to increase HEDIS rates, but the most important is to provide accurate and thorough documentation. Thankfully, HEDIS Nurses can help with that!
In addition to proper and timely documentation, you should also strive to meet deadlines for services and shift focus to preventative screenings and providing superior patient care. By doing these simple tasks, you can strive to increase your HEDIS rates.
Contact HEDIS Nurses today if you have other HEDIS related questions that need to be answered!
At HEIDS Nurses, we know how confusing the subject matter can be. Hopefully, we’ve cleared up some of the confusion surrounding the topic. However, if you have more questions regarding HEDIS and how our team of qualified chart abstractors can help with your HEDIS tasks, feel free to reach out to us. We have over 2021 years of experience and have helped countless clients take their HEDIS work to the next level. Give us a call today at (877) 328-2343 to learn more or request services.
To learn more about the HEDIS services that we offer, visit us on the web at HEIDS Nurses!