Staff from Highmark who are trained as registered nurses are conducting the annual Healthcare Effectiveness Data and Information Set (HEDIS®) medical record reviews from February through mid-May 2018. The reviews will be based on measurement year 2017 data.
Representatives from Highmark, Capital Blue Cross, and Independence Blue Cross may also contact you for medical records to assist with the Office of Personnel Management HEDIS reporting requirements for the Federal Employee Program.
The HEDIS report includes the medical record review for the assessment of compliance with a set of standardized performance measurements that health plans report on to the National Committee for Quality Assurance. The HEDIS data are collected and reported on an annual basis as part of Highmark's accrediting and governmental requirements.
The measurements this year are:
A random sample of members will be identified, and a representative from Highmark, Capital Blue Cross, or Independence Blue Cross will notify you either by telephone or fax to set up an onsite review or to have specific elements of the member’s medical records faxed or mailed for review.
For more information regarding HEDIS measures, please review the HEDIS Measures Reference Guide .
If you have any questions regarding the HEDIS report, please contact one of the following representatives from Highmark’s Clinical Service area: Anne Strout at 412-544-4592 or Joan Zalewski at 412-544-2696.