NCQA HEDIS® Compliance Auditing
HEDIS® COMPLIANCE AUDIT PROGRAM.
The only team perfectly equipped to help yours.
Since 1999, our team at DTS Group has been a trusted leader in the community for HEDIS® audits, delivering quality audits that minimize administrative burdens on your plan. Over the past 20+ years, our experts in healthcare performance auditing have conducted thousands of HEDIS® audits for health insurers across the U.S.
We’re licensed by The National Committee for Quality Assurance (NCQA) and are scheduling NCQA HEDIS® Compliance Audit services for the upcoming cycle. Schedule a consultation today to learn more.
Everything You Need To Know.
Our 6 Steps to Complete HEDIS® Audit Compliance
We've Got Your Back.
HEDIS® Audit Process Cycle
The HEDIS® Audit cycle runs from October to July every year. Our team creates a detailed workplan to complete all steps of the audit process for you. See the complete HEDIS® Audit cycle below to understand where your audit is in the process.
Incorporate the NCQA October Update to your Technical Specifications.
Join us each fall for our annual client meeting.
Start of Audit Cycle
Kick off the audit cycle and schedule your on-site date.
Survey Sample Frames and Roadmap Submission
Produce and validate survey submissions and submit Roadmaps.
Conduct on-site visits now through May. Don’t forget your 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® Audit compliance. Work with our audit teams to ensure a true representation of your plan’s results.
Supplemental Data Validation
Work with your audit team to approve supplemental data.
Preliminary Rate Review
Medical Record Review Validation
Submit Final Data
Finalize and submit locked data to NCQA.
Keep Momentum Going
HEALTHCARE EFFECTIVENESS DATA AND INFORMATION SET.
About the HEDIS® Audit
The Healthcare Effectiveness Data and Information Set (HEDIS®) is an audit used among government regulators, healthcare providers and others for evaluating and bettering the quality of health care plans across the country. The audit is divided into two parts, the first of which assesses a plan’s information systems capabilities, and the second is how they comply with HEDIS specifications.
Only certified auditors and licensed organizations are permitted to perform HEDIS® Audits, which are required for every health plan submitting HEDIS data to NCQA. Learn more about HEDIS Compliance Audit Certification today.
Hear it from the source.
What Our Clients Are Saying
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