Please review the documents below to achieve the highest quality of care for your patients, our members.
- Provider Tips for Optimizing HEDIS Results Booklet: This booklet will give you a complete list of claim codes and details on each HEDIS measure.
- HEDIS and Quality Management Programs Manual: This manual will give you details on HEDIS and our Quality Management Programs.
- HEDIS Measure Guidelines
- Follow-Up Care for Children Prescribed ADHD Medication (ADD)
- Adults’ Access to Preventive/Ambulatory Health Services (AAP)
- Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB)
- Breast Cancer Screening (BCS)
- Colorectal Cancer Screening (COL)
- Diabetes Care
- Use of Imaging Studies for Low Back Pain (LBP)
- Lead Screening in Children (LSC)
- Pediatrics/Adolescents Management
- Pharmacotherapy Management of COPD Exacerbation (PCE)
- Appropriate Treatment for Upper Respiratory Infection (URI)
- HEDIS Measure Guidelines for Behavioral Health Providers
- Interactive HEDIS Guidelines