Software

Compliance Reporter

A robust reporting and workflow management tool for payers that want to streamline and increase their Healthcare Effectiveness Data and Information Set (HEDIS®) quality measurement and reporting activities.

 

AmplifyYour HEDIS Activities

  • Simplify the complete hybrid review process through our NCQA-certified HEDIS quality rules processing engine. Generate samples, manage medical record abstractions, and create data submission files.
  • Support medical record review activities with online and offline data collection. Central data repository holds claims, membership, enrollments, lab, and pharmacy data, plus scanned charts.
  • Use web-based workflows to allocate chart reviews manually or systematically by location. Isolate measure-level and member-level detail for further research using powerful audit tools.
  • Eliminate time-consuming manual coding and measure updates with automated processes. Certify final hybrid rates within minutes, rather than days.
  • Increase efficiency throughout the HEDIS lifecycle. Create your CAHPS® survey sample frame in a few clicks. Manage both your HEDIS and analytics drawing from the same input files, with Risk Manager.
  • Receive up-to-the-minute results with in-line rate calculation. Quickly generate NCQA IDSS data files, the CMS-required PLD submission file, and Medicare patient-level data for final submission.

 

Simplified Collection, Review, Submission, and Reporting

  • Systematic medical record review

    • Improve data integrity with a centralized data repository, updated with the latest compliance details. Manage the entire medical record review process with single-source, clean data.
    • Streamline chart review with web-based workflows, including management chart review and chart chase management. Flexible task assignments accommodate various workflows to speed the process.
    • Stay on track with HEDIS process productivity summary, which includes measure status and a tally of remaining/completed charts by reviewer. Validate full compliance and exclusion reports from external reviewers. 
  • Comprehensive NCQA-specific reporting

    • Receive up-to-the-minute results for HEDIS measures and reporting with in-line rate calculations and live reports. Benefit from the full suite of NCQA HEDIS measures, which are updated annually.
    • Manage provider group, physician, and plan performance. Used with Risk Manager, Compliance Reporter provides graphical reports of overall measure performance, quality results trending, and plan/product line performance.
    • Calculate financial rewards for quality and pay-for-performance metrics. When paired with Risk Manager, Compliance Reporter supports full quality management
      Lifecycle, providing robust reporting and measurement.

Our outcomes

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