HEDIS Nurses Tackles Frequently Asked Questions Regarding HEDIS

HEDIS Nurses Tackles Frequently Asked Questions Regarding HEDIS

Are you working in the HEDIS field? If so, chances are you might need a bit of a refresher in all things HEDIS. Thankfully, HEDIS Nurses is here to help by providing answers to frequently asked questions regarding HEDIS.

What is HEDIS coding?

HEDIS stands for the Healthcare Effectiveness Data and Information Set. It is a set of standards that is used by health plans to measure their performance in regards to quality and care of service. Through HEDIS coding, services are standardized and categorized across the country to put them on a uniform scale.

What are the 6 domains of care for HEDIS?

There are 6 domains of care that all of the HEDIS quality measures fall under. These domains of care are:

  • Effectiveness of Care
  • Experience of Care
  • Access/Availability of Care
  • Health Plan Descriptive Information
  • Utilization and Risk-Adjusted Utilization
  • Measures Collected Using Electronic Clinical Data Systems.

What are HEDIS star measures?

HEDIS Star Measures were created as a HEDIS rating system by the Centers for Medicare and Medicaid Services (CMS). The system is in place to rate how a health plan’s Medicare Advantage program performs in regards to the designated HEDIS quality measures for that year. Star Measures are on a five-point scale, and the higher the rating, the better the health plan looks. If a health plan has a high enough HEDIS star rating, it is eligible to receive a bonus.

How can you improve Medicare STARS ratings?

HEDIS STARS Ratings are important and health plans should take active steps to increase them as much as possible. There are a few ways to do this, including:

  • Encouraging plan members to use their covered services
  • Focusing on improving the user experience
  • Improving communication with members

By having members utilize more services, improving their overall user experience, and increasing communication, health plans may be able to boost their HEIDS STARs ratings.

Who can help with HEDIS projects and tasks?

If you need help with HEDIS projects and tasks, don’t fret because you are not alone. HEDIS Nurses is here to help! Since 0 we’ve offered assistance to health plan providers that need help with their HEDIS work. With over 2020 years of experience, our skilled team of qualified chart abstractors can help with all things HEDIS. Whether you need help with chart abstractions or want to outsource all of your HEDIS work, we can help. Give us a call today at (877) 328-2343 to request our services!

To learn more about the reliable and quality HEDIS services that we offer, visit us on the web at HEDIS Nurses.