HEDIS® (Healthcare Effectiveness Data and Information Set) is a set of standardized performance measures developed by the National Committee for Quality Assurance (NCQA) to objectively measure, report, and compare quality across health plans. NCQA develops HEDIS® measures through a committee represented by purchasers, consumers, health plans, health care providers, and policy makers.
Referral is the process of sending a patient to another practitioner (ex. specialist) for consultation or a health care service that the referring source believes is necessary but is not prepared or qualified to provide.
Recording information about the services provided into a medical claim for billing. Without ACCURATE documentation of clinical care services, revenue could be lost because charges are incorrect or aren’t made at all.
Ensuring\that the events of the patient encounter are captured accurately, and the electronic health records properly reflects the services that were provided.