Encouraging care for parents and guardians of your Keystone HMO CHIP patients: Appropriate treatment for children with upper respiratory infection

February 8, 2021

​Independence is continuing its series of messages for the parents and/or guardians of our Keystone HMO Children's Health Insurance Program (Keystone HMO CHIP) members to help families manage their child's health care. The topics chosen are based on Healthcare Effectiveness Data and Information Set (HEDIS®) measures. We are sharing these topics with you to help support compliance with these measures and to encourage families to obtain these important services.

This month's message is about the appropriate treatment for children with upper respiratory infection.

Important information on HEDIS measures

Measure: The percentage of children 3 months –18 years who were given a diagnosis of upper respiratory infection and were not dispensed an antibiotic prescription.

  • Bacterial resistance to antibiotics is a global public health threat. Experts warn we may soon run out of treatment options for serious infections that are becoming antibiotic resistant.

  • Prescribing antibiotics inappropriately (e.g., for viral infections) and prescribing broad-spectrum antibiotics when a more targeted therapy is warranted, contributes substantially to the problem of resistance.

How you can help

Follow these tips to ensure patients get the care they need:

  • ensure patients are educated on the proper usage of antibiotics and long-term risks of antibiotic usage

  • ensure the correct diagnosis and CPT® codes are used when submitting claims for diagnoses and treatments

Stay tuned for more topics regarding care for your Keystone HMO CHIP patients.

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