Letters will be sent later this month to some offices to advise that they
may be selected to participate in an upcoming
medical record review required by the National Committee for Quality Assurance
(NCQA). During the first half of 2017,
Independence will review the medical records of some of our members regarding
services received. Independence is
required to undertake this review to comply with regulatory and accreditation
requirements.
Once participants have been determined, Independence will contact each
office to schedule an appointment for
a nurse who is trained in analyzing medical records to perform an on-site
review. We will review the records in
accordance with the quality standards set by NCQA in its performance
measurement tool known as the Healthcare
Effectiveness Data Information Set (HEDIS®).
Note: According to your Agreement with Independence, if your office
is selected for this review, participation is
mandatory.
If you have any questions regarding this upcoming NCQA-required medical
record review, please contact the Quality
and Risk Management Department at 215-241-2678.
HEDIS is a registered trademark of the National Committee
for Quality Assurance (NCQA). Used with permission.