The 2019 Health Care Effectiveness Data and Information Set (HEDIS®) chart reviews begin February 1st and continue through May 1st. We will be scheduling onsite review at most offices during this time. HEDIS is the most widely used set of performance measures in the managed care industry. Adapted for use by public health care purchasers, regulators, and consumers, HEDIS is part of an integrated system to establish accountability in health care. The HEDIS specifications are available on the McLaren Health Plan (MHP) website.

MHP utilizes internal staff to perform this review. MHP will be contacting your office staff to schedule these reviews. Some offices with very low volume (less than 10 records for review) will be asked to fax or mail in specific portions of medical records. HIPAA allows review and collection of this information without member consent, as it pertains to treatment, payment, and health care operations. MHP will assure that all reviews are conducted in accordance with HIPAA and MHP’s confidentiality standards.

During scheduled onsite review at your office, MHP staff will be meeting with appropriate office personnel to provide education, answer questions, and determine further needs for your office.

If your office utilizes an electronic record and would like to provide MHP off-site access to your charts for a limited period of time, we have staff trained and available to provide this service.

MHP thanks you in advance for your cooperation with the annual chart review and data collection process.

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