HEDIS® Audits

Since its introduction in 1993, the Healthcare Effectiveness Data and Information Set (HEDIS®) has evolved to become the gold standard in health plan performance measurement. HEDIS is a set of performance measurements or indicators used to compare organizations “apples-to-apples” in terms of quality or value rather than price. In general, HEDIS is important to employers, government agencies, and consumers who wish to compare various organizations within a market. HEDIS performance is an integral component of CMS Star rating, NCQA plan accreditation, Health Exchange scoring, and incentive programs for Medicaid plans.

Learn more about NCQA’s HEDIS® program

We audit HEDIS submissions for a vast range of clients, spanning from large multi-national organizations to small SNP plans. We provide add-on value to organizations by meeting their additional audit needs such as Health Exchange Quality Reporting, Provider Quality Performance Measurement, and State Specific Quality Reporting.

Meeting Your HEDIS Audit Needs:

We collaborate with a goal of permitting your organization to report the best and most accurate rates reflecting your organization’s true performance.

Attest Health Care Advisors is the market leader in Healthcare Effectiveness Data and Information Set (HEDIS) audits. The team at Attest has been performing audits since before the inception of the NCQA’s HEDIS Compliance Audit™ program in 1997. Attest audits over 1,400 HEDIS submissions annually from over 70 different organizations including many of the top commercial, Medicaid, and Medicare plans nationally.

HEDIS audits must be led by a NCQA-Certified HEDIS Compliance Auditor (CHCA). Our team includes the largest number of Certified HEDIS Compliance Auditors of any NCQA-licensed organization.

Through our large and diverse client base, we have an unmatched level of experience reviewing and understanding vendors, transaction systems, source code programming, medical records abstraction and supplemental data sources. Our client diversity provides insight to understand and identify drivers of atypical plan performance, such as geographical trends, unique member subpopulations, or other market forces that is beyond compare.