HEDIS Compliance Audit Program
The Only Team Equipped To Help Yours

 

Trusted Since
1999

We’ve been leaders in the HEDIS® community since its inception. DTS Group delivers an efficient and effective audit that leverages our deep experience while minimizing the administrative burden on your plan. We are licensed by The National Committee for Quality Assurance (NCQA) and are currently scheduling and planning NCQA HEDIS Compliance Audit services for the upcoming cycle.

 

The Six Steps to Complete Compliance
Here's Everything You Need To Know

 

A Detailed Proposal

May we send you a bid? Our proposal describes the audit process and our work activities to help you make an informed decision. A dedicated audit team is assigned and a complete work plan is documented.

Customized Approach

Our full-service approach is tailored to your plan. Our certified Project Management Professionals (PMPs) work with you to create solutions that fit your needs. Training and education are provided and we will not burden your internal staff with excessive project administration and management tasks. We help you focus on your results.

Expert Support

Our teams have significant HEDIS and health care consulting experience. Subject matter specialists perform all audit functions. Code review and medical record reviews are accomplished by highly skilled IT and clinical resources. By employing only professionals with extensive field experience, DTS Group is able to concentrate on delivering results.

Analysis and Feedback

Our team will assess the completeness and correctness of your data and results using easy to follow interviews, measure-specific queries, and our deep industry experience. Feedback is succinct and timely so your plan can identify potential issues early in the audit process.

Best-In-Class Tools

We have developed industry-leading tools to streamline the audit process and assure all audit guidelines and specifications are met. Our goal is an on-time, complete, and accurate data submission. We embrace technology to facilitate the entire audit process and create a transparent audit trail for the many documents, due dates, and interactions associated with your audit.

On-Time Reporting

Our schedule will get you through the audit cycle on time. We support all of your Federal, State, and other agency-defined reporting requirements. We work with your team to strike the perfect balance of content and clarity to ensure your plan meets all audit requirements.

 

Why Choose DTS Group?
We've Got Your Back.

 

October

Incorporate October Update to your Technical Specifications.

November

Join us for our annual client meeting.

December

Kickoff the audit cycle and schedule your onsite date.

January

Produce CAHPS submissions and submit Roadmaps.

February

Conduct onsite visits now through May. Don't forget your supplemental data!

March

Work with your audit team to approve supplemental data.

April

Process hybrid data and conduct Medical Record Review.

May

Close outstanding items and complete MRRV.

June

Finalize and submit locked data to NCQA.

July - September

Keep the momentum going, pursue outreach initiatives, plan for next year.

Quick Tip:
Supplemental Data

Get the most out of your reporting experience. Top plans leverage supplemental data to document care delivered to members outside of claims and encounter data. It is important to work with your auditor to properly document supplemental data for HEDIS compliance.

Work with our audit teams to ensure a true representation of your plan’s results.

 

Our Team Is Ready to Help Yours
Contact Us With Confidence Today

 
 

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