2010 HEDIS® reviews

Annually, Priority Health participates in the Healthcare Effectiveness Data and Information Set (HEDIS) methodology of collecting, measuring and reporting performance indicators. By doing so, Priority Health has the opportunity to measure the quality of care our members receive. In addition, we're able to compare ourselves with other exceptional plans throughout the country, share this information with the public and identify areas for improvement within the plan.

HEDIS is the most widely used set of performance measures in the managed care industry and is developed and maintained by the NCQA. HEDIS is part of an integrated system to establish accountability in managed care and contains 70 measures across eight domains of care.

By contract, all of our providers have agreed to participate in Quality Assurance (QA) reviews, and HEDIS is considered one of those QA reviews. We've agreed to provide you with 30 days advance notice of these reviews. This communication serves as that notice.

Under HIPAA, HEDIS is an approved activity, as it's part of normal health care operations. We may conduct some reviews via fax to minimize interruptions to offices. If you'd prefer to have a reviewer visit your office instead, let us know. Please welcome these reviewers into your office and assist them if they have questions. If you have questions about the process or reviewers, please feel free to contact Marcia Bartlett at 231 932-7964.

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