NCQA-HEDIS Reporting, Ratings & Payments

Optimized HEDIS Reporting for Health Plans

Utilize HEDIS To Full Effect

The NCQA governs HEDIS for health plans to manifest, analyze, and report performance measurements year after year. Use it to good effect.

Gauge Performance

Measure performance through calculated benchmarks; get hands-on experien with our audit specialist features and claim-level checks.

Enhance Quality and Ratings

Through our full suite of services and member engagement solutions, you get to report quality measures and witness enhanced ratings.

Simplified Processes

Apart from the complex HEDIS reporting program undergoing simplistic resolve, get a hold of customized reports across the list of measures.

Experience Is A Plus

With more than 5 years of experience in healthcare IT, with us, physicians, PPOs, Medicare & Medicaid payers excel in HEDIS Quality reporting.

Reduce Costs; Eliminate Burden

Avoid extra costs and resource utilization with our expert team of data managers. We run optimized data assimilation processes.

Meet the CMS HEDIS Quality Reporting Requirements for Star Ratings

HEDIS Quality Reporting and Analysis

  • CMS star ratings 2021 are just a few steps away because we believe in quality outcomes.
  • HEDIS score and star ratings are a mixture of critical analysis and targeted knowledge.
  • Address HEDIS program along with hybrid and public reporting most effectively.
  • Healthcare Effectiveness Data and Information Set measures gauge a health plan’s performance and make it market-ready.

How Is HEDIS Data Collected?

  • By leveraging surveys, medical charts, and insurance claims from hospital stays, clinic visits and procedures.
  • More importantly, the HEDIS reporting analysts at Avant-Garde BPO guide the way at every stage of data acquisition.
  • Deadlines year after year are crucial; we familiarize ourselves with the HEDIS reporting timeline.

Tend to Five Domains in HEDIS Data Submission

  • As HEDIS comprises of five domains, tend to all of them at once with Avant-Garde BPO.
  • Is HEDIS reporting mandatory? Yes, it is; we’re here to simplify NCQA health plan accreditation standards.
  • Physicians and health plans have everything to gain, from understanding HEDIS to reporting Medicare measures 2021.
  • Comprehensive submission of measures from each domain.
  • Elaborate comparison of health plans by reporting the relevant measures for SNPs.

Medicare Advantage Special Needs Plans

  • Medicare SNPs in healthcare classify as one of the Medicare Advantage Plans (like an HMO or a PPO).
  • Employers and individuals use HEDIS results to quality of health plans; mark the efficacy of your plan and make it permanent with Avant-Garde BPO.

Calculate HEDIS Rates: Administrative and Hybrid Data

The Core HEDIS Quality measures are designed for both public and private payers to hold them accountable for quality of general medical facilities and specialty services.

Measures for quality reporting in 2021 are the difference moving forward for health plans. They establish the criteria to attract consumers and enroll them with confidence. Payers with high-performance health plans grab the majority market share and convince potential beneficiaries.

There are three data collection methods including Administrative, Hybrid, and Survey. Part of the reviewing mechanism under NCQA involves sifting through electronic medical records of the past years.

Administrative Data

is collected using insurance claims, registration systems, medical offices, labs, clinics, and pharmacies.

Hybrid Data

is a random selection of data. Its purpose is to supplement administrative data with information collected through EHRs.

CAHPS Survey

measures satisfaction levels of care received in areas such as claims processing, customer service handling, and timings of care.

Hey! Feel free to report HEDIS measures 2021 with Avant-Garde BPO.

I am here to take you through the data submission process. It is where health plans see the face of acceptance for purchasers and consumers. I will call you back once you submit your info below.