HEDIS Abstraction for Health Insurance Industry
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HEDIS Abstraction

Measuring health care performance is critical for health plans to better evaluate the level of service their providers deliver, identify performance gaps and make any needed changes to cultivate continued customer satisfaction and loyalty.

The Healthcare Effectiveness Data and Information Set (HEDIS) is widely used to measure and report on health care performance. Health plans that want to obtain accreditation via HEDIS must gather data about patient care, organize it into specific measures defined by HEDIS and determine if specific criteria for HEDIS measures have been met.

By following best practices in medical record retrieval, managing, coding and reporting, companies can streamline the process, reduce costs and improve reliability. In particular, Verscend will provide the following:

Online Medical Record Retrieval

Efficient records retrieval and accurate coding are essential to the successful completion of the review process. Verscend’s RapidRetrieve™ system can scale to any volume of requests while maintaining fast turnaround times.

Detailed Audit of Records

The audit determines if the quality of care measures, as defined by HEDIS, have been met.

HEDIS Reviews

Reviews cover 74 measures across 8 domains of care (HEDIS 2009).

Patient Specific Scorecards

Scorecards are provided for each measure identified by the health payer.

Reporting

A variety of formatted reports are available to the health plan to provide project visibility.

HEDIS Abstraction Services