Our annual medical record review begins next month. HEDIS, which stands for Healthcare Effectiveness Data Information Set, is a National Committee for Quality Assurance (NCQA) tool used by health plans, like ConnectiCare, to measure performance of the services and care our members receive.
We use the results from the annual HEDIS review to improve the quality of members’ care and strengthen our educational programs for our providers and members.
If you have ConnectiCare members that are included in the random HEDIS sample, we may request medical record information from your office. If this is the case, we may ask your office to provide the patients’ medical records through:
- a scheduled visit to your office
- a faxed request
- access to the patient’s electronic medical record (EMR)
- an electronic exchange of information via a secure file transfer (FTP) site
Under the Health Information Portability and Accountability Act (HIPAA) Privacy Rule, data collection for HEDIS is permitted, and the release of this information requires no special patient consent or authorization. Please be assured members’ personal health information is maintained in accordance with all federal and state laws. Data is reported collectively without individual identifiers. All of the health plans’ contracted providers’ records are protected by this.
We appreciate your cooperation and your timely response to our requests. Our ConnectiCare providers play an important role in promoting the health and wellness of our members. We will do what we can to work quickly and efficiently with you and your office staff to get the information needed.