HEDIS Tools
CHOC Health Alliance wants to ensure quality, cost-effective health care solutions for our members, and our Quality Improvement program aims to advance patient safety and care so our members can stay healthy. As you know, HEDIS® is a tool that is used to measure quality of care; access to care; and member satisfaction. You can improve your HEDIS® scores significantly by submitting accurate and complete coded claims and encounter data for each service rendered.
Why is HEDIS® important to you?
- HEDIS® data ensures that optimal healthcare and service are provided to our members
- It helps you identify non-adherent members so you can ensure they receive needed services
- It provides information on how you compare and rank, with other providers
- It’s the centerpiece of your quarterly Score Cards and the basis for incentive programs
We hope these documents below will provide you with the necessary information you need to be successful in your practice. If you have any questions or would like to discuss your specific challenges with these measures, we’d love to hear from you. Please contact your Provider Relations Representative directly or email us at ProviderRelations@choc.org.
With HEDIS®, every member counts!
HEDIS® Provider Guides
2018 CHA Clinical Excellence Quick Reference Guide
CHA 2016 Top 30 Pediatric ICD-9 to ICD-10 Codes
(AAB) – Adults with Acute Bronchitis
(AAP) – Adults’ Access to Preventive/Ambulatory Health Services
(ADD) – Follow-Up Care for Children Prescribed ADHD Medication
(AMR) – Asthma Medication Ratio
(AWC) – Adolescent Well-Care Visit
(CAP) – Children and Adolescents’ Access to Primary Care Practitioners
(CBP) – Controlling High Blood Pressure
(CDC) – Comprehensive Diabetes Care
(CHL) – Chlamydia Screening
(CIS) – Childhood Immunizations
(CWP) – Appropriate Testing for Children with Pharyngitis
(FUH) – Follow – Up After Hospitalization for Mental Illness
(IMA) – Immunizations for Adolescents
(LSC) – Lead Screening
(MMA) – Medication Management for People with Asthma
(PPC – Postpartum) – Prenatal Care – Postpartum
(PPC – Timelines) – Prenatal Care – Timeliness
(URI) – Appropriate Treatment for Children with Upper Respiratory Infection
(W15) – Well Child Visits First 15 Months of Life
(W34) – Well Child Visits 3-6 Years
(WCC) – Weight Assessment and Counseling
Cozeva®
HEDIS® is a registered trademark for the National Committee of Quality Assurance (NCQA)
Cozeva® is a registered trademark of Applied Research Works, Inc.