Tag - HEDIS

Provider Alert!

Provider Alert! Annual HEDIS ® Medical Record Review Process to Begin in February

Date: January 26, 2021 Attention: Primary Care Providers Review Period: February through May 2021 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: TCHP would like to inform network providers that the HEDIS® medical record data review process will begin in early February 2021 and proceed [...]

Provider Alert!

Provider Alert! Attention: NCQA HEDIS Measure Changes

Attention: PCP, OB/GYN and Endocrinologist Providers Effective Date: January 1, 2020 Call to action: Texas Children’s Health Plan (TCHP) would like to inform you of changes to the National Committee for Quality Assurance (NCQA) HEDIS Technical Specifications released on July 1st, 2020. How this impacts providers: These changes are effective as of January 1, 2020. Please submit all claims timely, as soon as services are rendered, and use appropriate codes to reflect the services provided particularly for Well-Care Visits and THSteps. REVISED MEASURES Well-Child Visits [...]

HEDIS Toolkit Offers Benefits to Providers

Members are cared for as HEDIS measures are met  Texas Children’s Health Plan developed a HEDIS Toolkit that contains helpful information regarding the measure requirements, standards and codes to use that are acceptable for HEDIS reporting. The new toolkit can be accessed here. This toolkit will serve as a reference form that can be used to code the type of appointments made and ensure that all of the HEDIS standards are met.  This will help providers maintain high quality care and [...]

Provider Alert!

Provider Alert! Metabolic Monitoring for Children and Adolescents on Antipsychotics Reminder

table { border-collapse: collapse; }tr,td { border: solid thin; } Attention: Primary Care and Behavioral Health Providers Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Texas Children’s Health Plan (TCHP) is actively working on a Performance Improvement Project (PIP) for members, ages 1-17, who [...]

Inovalon

Understand your patients’ care gaps and improve your quality of care with the Inovalon HEDIS® Metrics Tool

Texas Children’s Health Plan PCPs and OB/GYN providers can now access data via the Inovalon HEDIS Metrics Tool through our Provider Portal. This new tool allows you to use performance and patient data so that you can independently manage your patient population, as well as improve the quality of disease management throughout your panel. Key features such as member-level gap reports and detailed HEDIS quality rates contribute to improving your provider incentive program rates. If you have any questions about [...]

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 [...]

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 [...]