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Quality

The Quality Improvement Program includes initiatives to ensure that members are receiving age-appropriate preventive health screenings and interventions to optimize health.

This information will assist providers with managing patient care based on industry-standard clinical practice guidelines.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Care Coordination

Get some tips you can use to raise patient awareness of all the great work you are doing to provide care coordination and involve the patient in decision making.


Electronic Health Records (EHR) Incentive Programs

CMS hosts regular webinars to educate providers on topics related to EHR Incentive Programs. If you use EHR, are interested in EHR capabilities, or want to learn how your practice can benefit, please visit the CMS website for more information. 

2019 HEDIS Toolkit

2019 HEDIS® AT-A-GLANCE: KEY ADULT MEASURES

HEDIS® Adult Resource Guide

HEDIS® Guide Adult Quick Tips

2019 HEDIS® AT-A-GLANCE: KEY BEHAVIORAL MEASURES (17 Years and Younger)

2019 HEDIS® AT-A-GLANCE: KEY BEHAVIORAL MEASURES (18 Years and Older)

Every year CMS or NCQA may ask your patient the following questions. How do you rate?

Important Information on CPT II and HCPCS Codes

We’re asking our providers to make sure to use accurate CPT Category II codes to improve efficiencies in closing patient care gaps and in data collection for performance measurement.

KEY PEDIATRIC MEASURES

HEDIS® Pediatric Resource Guide

Other Helpful Documents

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Last Updated On: 2/4/2019
Welcome Prescription Drug Plan members! We have important information to share with you about your 2019 plan. Read More. ×