HEDIS

If you're involved in the implementation of HEDIS, there is no better way to prepare than by joining ACK Hotline.

 

Don't Lose Some of Your Reimbursement.

 

ACK Hotline is your solution for your Medical Reimbursement.  A support service that will assist you with :

 

PQRS                                                               HEDIS

National Quality Measures                        ICD-10

Coding                                                            Meaningful Use

Value-Based Modifier                                 MRA

 

How It Works:

Unlimited Email Support

Unlimited Calls

No Contracts ~ Cancel When You Want

$59.00 per Month

Service is:  Monday through Thursday  8:00AM to 5:00PM

                    Friday 8:00AM to 1:00PM 

 

Avoid the penalties and understand how to navigate in today’s medical reimbursement !!!

 

 

Maximize Your Incentive Bonus

  

 For More Details: 305-227-2383  or 1-877-938-9311 ( Ask For Felicia )

 

 

HPP Management Group, Corp.

5201 Blue Lagoon Dr.

Suite 815

Miami, FL 33126

 

Preparing for HEDIS 2015

With HEDIS 2014 completed, now is the time to start planning for HEDIS 2015. While the active medical record collection period is short, HEDIS is a year round activity. There are many opportunities that can be acted on now to make next results even better for many it’s a matter of data gaps and identifying where those gaps exist and taking action to close them can drastically improve your HEDIS and STARs rates next year.

 

Reviewing HEDIS 2014 results with claims data throughout the year can give you an insight into where data gaps with quality of care measures that impact HEDIS and STARs results. When analyzing this information, you can identify interventions for your health plans, providers and members. It is important to prioritize interventions by the impact they can yield.
For health plans, consider what is driving your gaps.

• Are gaps resulting from network leakage due to members visiting providers that are not participating with the plan and aren’t obligated to provide medical record information? If so, work with your benefits department to identify ways to message members about in-network benefits.
• Are there large provider groups that are resistant to cooperating? 
• Do they have EMR? What incentives can you provide to encourage participation?

Provider engagement is another key way to improve HEDIS 2015 and Stars results. Providers are challenged with day-to-day operations of their offices and may not have the resources available to identify members needing preventative screenings or chronic care management. Targeted reports providing them with up-to-date patient information can assist them in their outreach efforts to encourage members to receive timely care. In addition, identify ways to offer providers options for HEDIS 2015 that can reduce provider intrusion. Do they have EMR that can be accessed remotely? Do they want to schedule early so they can anticipate and schedule your HEDIS requests with other plans? Sometimes it’s the little things that make the provider’s life easier that can help with getting the responsiveness you need for your HEDIS data collection.

 

The health care system is challenging to navigate. By making it easier to understand, members can become more engaged in managing their health. Depending on your membership demographics some outreach efforts are more effective than others. Consider a multi-prong approach such as mailings, voicemail and health educator outreach to members based on preventative screenings and chronic care management. Optimize care management programs to remind and follow-up with members needing services. Sometimes members need a call to action and some guidance – it’s a win-win.

 

HPP Management Group and AccuChecker  helping providers to meet the goals of:

 

·         HEDIS

·         PQRS

·         Meaningful Use

·         National Quality Measures

 

 

 

 

FOR MORE INFORMATION PLEASE CONTACT:

HPP Management Group, Corp.

Developers of the AccuChecker Product Line

Phone: (305) 227-2383

Email: sales@accuchecker.com

Website: http://www.accuchecker.com

 

BE PART OF OUR SOCIAL SITE – FEEL FREE TO JOIN

 

Like Us on Facebook:       https://www.facebook.com/Accuchecker

Follow US on Twitter:      https://twitter.com/HPPAccuchecker

Join our Group:                 https://www.facebook.com/groups/1467439953488495/

Yahoo Group:                   https://groups.yahoo.com/neo/groups/accuchecker/info

HEDIS for CY2015

HEDIS measures for two types of care: preventive health care and condition-specific care. For more details :  www.accuchecker.com

 

The HEDIS measurement set includes over 80 quality indicators for commercial, Medicare, Special Needs Plan (SNP), Medicaid and Health Insurance Marketplace including Consumer Operated and Oriented Plan (CO-OP) reporting. Changes for HEDIS 2015 reporting are outlined below. For additional details on the revised measure specifications and general guidelines, documents contact us or e-mail our HEDIS team at hppaccuchecker@gmail.com 

New Measures

For HEDIS 2015 reporting, NCQA has added the following new measures. Since they are first-year measures, they are not eligible for public reporting by NCQA. However, individual states may opt to report organization-specific results.

• Non-Recommended PSA-Based Screening in Older Men
• Use of Multiple Concurrent Antipsychotics in Children and Adolescents
• Metabolic Monitoring for Children and Adolescents on Antipsychotics
• Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics

Retired Measures

Beginning with HEDIS 2015, the following measures or measure indicators have been retired from the HEDIS reporting set.

• Glaucoma Screening in Older Adults
• Cholesterol Management for Patients With Cardiovascular Conditions
• LDL-C Screening and LDL-C Control Indicators for Comprehensive Diabetes Care
• Anticonvulsants Indicator for Annual Monitoring for Patients with Persistent Medications

Measures Eligible for Rotation

Commercial and Medicaid organizations are eligible to rotate the following measures for HEDIS 2015 reporting.

• Adult BMI Assessment
• Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
• Childhood Immunization Status
• Immunizations for Adolescents
• Lead Screening in Children
• Colorectal Cancer Screening
• Comprehensive Diabetes Care
• Well-Child Visits in the First 15 Months of Life (Medicaid only)
• Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life (Medicaid only)
• Adolescent Well-Care Visits (Medicaid only)

FOR MORE INFORMATION PLEASE CONTACT:

HPP Management Group, Corp.

Developers of the AccuChecker Product Line

Phone: (305) 227-2383

Email: sales@accuchecker.com

 

Website: http://www.accuchecker.com

 

BE PART OF OUR SOCIAL SITE – FEEL FREE TO JOIN

 

Like Us on Facebook:           https://www.facebook.com/Accuchecker

Follow US on Twitter:          https://twitter.com/HPPAccuchecker

Join our Group:                    https://www.facebook.com/groups/1467439953488495/

Yahoo Group:                       https://groups.yahoo.com/neo/groups/accuchecker/info

 

For More Info: 

Contact :                  Paul G. Silverio-Benet

                                    psilben@hppcorp.com

                                    hppaccuchceker@gmail.com

               

HEDIS - Key Terms

　

Key Terms to Know

–Denominator = eligible members of the population

–Numerator = members that met the criteria of a measure •Example: 100 members of which 20 met criteria = 20/100 = 20%

–Anchor date = the specific date the member is required to be enrolled to be eligible for the measure

–Provider specialty = certain measures must be provided by a specific provider specialty

HEDIS 2015

HEDIS 2015

 

Proposed New Measures

·         Non-Recommended PSA-Based Screening in Older Men

·         Non-Recommended Colorectal Cancer Screening in Older Adults

·         Use of Higher than Recommended Doses of Antipsychotics in Children and Adolescents

·         Use of Multiple Concurrent Antipsychotics in Children and Adolescents

·         Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics

·         Follow-up Visit for Children and Adolescents on Antipsychotics

·         Metabolic Screening for Children and Adolescents Newly on Antipsychotics

·         Metabolic Monitoring for Children and Adolescents on Antipsychotics

Are you Ready for HEDIS 2015 ?

Now is the time to prepare for HEDIS 2015

HEDIS 2014 will be reviewed / audited during FSY 2015

Are you collecting the incentives for HEDIS ? 

The solution is simple, AccuChecker. AccuChecker is the complete tool for medical reimbursement , and deals with today’s topics of HEDIS and PQRS. For more  details please call 305-227-2383 or 1-877-938-9311.

 

·         Schedule a Webinar

·         Web page:   www.accuchecker.com

·         Ask for a Free Trial

 

 

BE PART OF OUR SOCIAL SITE – FEEL FREE TO JOIN

 

Like Us on Facebook:           https://www.facebook.com/Accuchecker

Follow US on Twitter:          https://twitter.com/HPPAccuchecker

Join our Group:                    https://www.facebook.com/groups/1467439953488495/

Yahoo Group:                       https://groups.yahoo.com/neo/groups/accuchecker/info

 

 

 

CONSULTING SERVICES

Experience, confidentiality, the right team plus proven software

HEDIS

HEDIS

 

Are you collecting the HEDIS incentive with the Health Plans your Participate  with ?

 The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service. Altogether, HEDIS consists of 81 measures across 5 domains of care. Because so many plans collect HEDIS data, and because the measures are so specifically defined, HEDIS makes it possible to compare the performance of health plans on an "apples-to-apples" basis

 

Sample below shows the requirements to meet the measure for  Comprehensive Adult Diabetes Care ( CDC ):

 The use of the following CPT CATII Codes will identify that a service was performed for the measure:

 

For HbA1c:

3044F: Most recent hemoglobin A1c (HbA1c) level less than 7.0% (DM)

3045F: Most recent hemoglobin A1c (HbA1c) level 7.0-9.0% (DM)

3046F: Most recent hemoglobin A1c level greater than 9.0% (DM)

 

For LDL-C:

3048F: Most recent LDL-C less than 100 mg/dL (CAD) (DM)

3049F: Most recent LDL-C 100-129 mg/dL (CAD) (DM)

3050F: Most recent LDL-C greater than or equal to 130 mg/dL (CAD) (DM

 

For Eye:

2022F: Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed (DM)

For Foot:

 

2028F: Foot examination

performed (includes examination through visual inspection; sensory exam with monofilament; and pulse exam - report when any of the 3 components are completed) (DM)

 

Understanding what is required for each HEDIS measure is key to the practice and your continued  participation with the various Health Plans. When the  Health Plans Score successfully  you the provider receive the incentive.

 

AccuChecker provides a HEDIS Module to assist you  in understanding each HEDIS measure and shows how to correctly code to qualify for the Measure.

 

www.accuchecker.com

For more details, a Free Trial or Webinar call : 305-227-2383  or 1-877-938-9311

 

Be Part of Our Sites

Our Social Sites   - Please feel free to Join:

Like Us on Facebook:           https://www.facebook.com/Accuchecker

Follow US on Twitter:          https://twitter.com/HPPAccuchecker

Join our Group:                    https://www.facebook.com/groups/1467439953488495/

Yahoo Group:                       https://groups.yahoo.com/neo/groups/accuchecker/info

 

HEDIS and AccuChecker

www.accuchecker.com

 

The AccuChecker OnLine is an Internet service with:

 

·         Procedures – CPT, Category II and HCPCS codes.

·         Diagnoses codes (ICD-9-CM and ICD-10-CM).

·         Free HOT-LINE SUPPORT.

·         HEDIS

·         PQRS ( P4P )

 

The HEDIS Module helps you identify the various Measures and how to correctly code to qualify the measure.

 

Understand what it takes to code for the Measure and what documentation should be in place.

 

Two Modules Available:         BASIC  or CLASSIC   

Two Versions Available :         STATE  or NATIONAL

  

You may purchase via  PAYPAL or CREDIT CARD

 

Accuchecker , the ONE resource for all your REIMBURSEMENT needs.

 

Call for more details : 305-227-2383   or   1-877-938-9311 

Call for your    Free Trial  or Webinar

 

Our Social Sites   - Please feel free to Join:

Like Us on Facebook:           https://www.facebook.com/Accuchecker

Follow US on Twitter:          https://twitter.com/HPPAccuchecker

Join our Group:                    https://www.facebook.com/groups/1467439953488495/

Yahoo Group:                       https://groups.yahoo.com/neo/groups/accuchecker/info