Tag - HEDIS

The new and improved Provider Portal is here!

The upgraded Texas Children’s Health Plan Provider Portal is now live! We have worked to bring a revamped user experience to our entire provider network. Our goal is to empower our providers with the tools to access accurate, timely data, so that they are able to deliver the best possible care to our members and their families. The redesigned portal features: Improved functionality for the claims, appeals, and messaging center Health Management Tools menu Access to Healthcare Effectiveness Data and Information Set (HEDIS®) [...]

Be a HEDIS hero

The National Committee for Quality Assurance (NCQA) is a non-profit organization that measures the quality of healthcare across large populations. NCQA does this through its Health Effectiveness and Data Set, also known as HEDIS. HEDIS measures are a set of evidence-based standards that Texas Children’s Health Plan is committed to improving upon in order to provide the best care for our members. Making changes across your patient population is easier than you think! In fact, you can become a HEDIS [...]

Be a HEDIS HERO for your pregnant patients

The National Committee for Quality Assurance (NCQA) is a non-profit organization that measures the quality of healthcare across large populations. NCQA does this through its Health Effectiveness and Data Set, also known as HEDIS. HEDIS ‘Measures’ are a set of evidence based standards that Texas Children’s Health Plan is committed to improving upon in order to provide the best care for our members. Making changes across your patient population is easier than you think! In fact, you can become a [...]

ADHD Provider Tool Kit:  Treatment

What is it? The ADHD Provider Tool Kit is the online Texas Children’s Health Plan resource for a wide range of relevant information to assist the diagnosis, treatment, and management of patients with ADHD and their families. The goal is to provide information sources for providers who frequently see patients with this diagnosis. Treatment planning The Tool Kit includes algorithms for providers to help ensure a thoughtful and well-rounded treatment plan for members with ADHD. Interventions for patients and their caregivers as [...]

Be a HEDIS HERO for Childhood Wellness

The National Committee for Quality Assurance (NCQA) is a non-profit organization that measures the quality of healthcare across large populations. NCQA does this through its Health Effectiveness and Data Set, also known as HEDIS. HEDIS measures are a set of evidence based standards that Texas Children’s Health Plan is committed to improving upon in order to provide the best care for our members. Making changes across your patient population is easier than you think! In fact, you can become a [...]

Be a HEDIS Hero

The National Committee for Quality Assurance (NCQA) is a non-profit organization that measures the quality of healthcare across large populations. NCQA does this through its Health Effectiveness and Data Set, also known as HEDIS. HEDIS measures are a set of evidence-based standards that Texas Children’s Health Plan is committed to improving upon in order to provide the best care for our members. Making changes across your patient population is easier than you think! In fact, you can become a HEDIS [...]

ADHD Provider Toolkit

What is it? Texas Children’s Health Plan is pleased to announce the unveiling of the ADHD Provider Toolkit. The ADHD Provider Toolkit is a go-to site for a wide range of relevant material to assist clinicians in the diagnosis, treatment, and management of patients with ADHD and their families. The goal is to provide information sources for the primary care provider who frequently sees patients with this diagnosis, thereby making evidence-based practices and tools available on the desktops of busy [...]

Well Child Visits – Provider Incentive Program HEDIS measure has changed

Providers will now be measured on W156, well-child visits in the first 15 months of life (6 or more visits). Members assigned to your panel within the designated age range are eligible in January. Tell your Texas Children’s Health Plan patients that they can get up to 2 free packs of disposable diapers for completing their 12-month and 15-month well-child checks! Limit 1 pack of diapers per visit. Well-child visits are part of important HEDIS (Healthcare Effectiveness Data and Information Set) [...]

HEDIS Spotlight

HEDIS® (Healthcare Effectiveness Data and Information Set) is a widely used set of performance measures that ensures our members are getting the best health care possible. It is extremely important that our providers understand HEDIS® specifications and guidelines. This section highlights different HEDIS metrics in addition to providing descriptions of the measures, correct billing codes to support services rendered, and tips to direct you to corresponding resources and tools.   MEASURE: FOLLOW-UP AFTER HOSPITALIZATION FOR MENTAL ILLNESS MEASURE DESCRIPTION: Members 6 years [...]