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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.

The information on this page provides useful information and tools for managing patient care based on industry-standard clinical practice guidelines.

Preventive Depression Screening Program

This program promotes collaboration, continuity and coordination between medical and behavioral health care.

Million Hearts Action Guide
The Hypertension Control: Change Package for Clinicians  is a quality improvement tool for ambulatory clinical settings to improve hypertension control. This guide includes change concepts, change ideas, and evidence or practice based tools and resources.

2017 HEDIS Toolkits

HEDIS ensures health plans are offering quality preventive care and service to members.

Information concerning the mental and emotional well-being of patients.

Information to help you submit consistent, detailed claims to help reduce medical.

Important information for Medicare providers.

HEDIS reference guide for Pediatric care.

A HEDIS quick reference guide for Pediatric care

This document details the importance of coordination of care.

2017 HEDIS At-a-Glance Key Adult Measures

2017 HEDIS At-a-Glance Key Pediatric Measures

2017 HEDIS and CMS Stars At-a-Glance Key Measures (Senior Care)

2017 HEDIS At-a-Glance Key Behavioral Measures (17 Years and Younger)

2017 HEDIS At-a-Glance Key Behavioral Health Measures (18 Years and Older)

This form is to assess care needs for older adults.

Other Resources

WellCare shall monitor providers against the following standards to ensure members can obtain needed health services within the acceptable appointment time frames, in-office waiting times, and after-hours standards.

New York Confidential Case Report Form

Promoting cultural and linguistic competency self-assessment checklist for personnel providing primary health care services

A form used to order copies of the New York State Health Care Proxy

The documentation standards listed here applies to all medical records

The documentation listed here applies to all obstetrical records

This tool is designed to be a working record for all WellCare members.

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Last Updated On: 12/28/2016