HEDIS reporting season is here! We need your support in collecting information from our members’ medical records for the 2024 reporting year.

The focus of Healthcare Effectiveness Data and Information Set (HEDIS) is to measure the health plan’s performance rather than individual provider performance. Participation with the HEDIS Project may assist in identifying gaps in care that are closed. Established by the National Committee for Quality Assurance (NCQA), annual HEDIS reporting is required of all HealthChoices plans by the Pennsylvania Department of Human Services and is necessary to maintain our NCQA accreditation.

Our Quality Management department has extensive experience in chart review and quality measurement. Registered nurses from this department will rely on your cooperation to arrange for the collection of the requested medical records needed for HEDIS reporting.

• We will continue our process to ensure this is an easy and safe process for your office. 
• The preferred method of medical record collection is read-only access to your site’s EMR system for our staff members.
• We will coordinate with your office to identify the medical records needed for review. 
• Please contact Pearl Taylor, HEDIS Coordinator, at 215-991-4283 or ptaylor@jeffersonhealthplans.comto discuss chart collection options.
• We will coordinate with your office staff on how to get requested records to reduce traffic in your office. If needed, a fax number and address will be provided in the request letter containing the member information.
• If necessary, our staff will arrange to visit your office to scan documentation to a secure laptop to avoid copying and transporting records.

As a friendly reminder, cooperation with our quality assurance efforts is part of your provider contract.

We look forward to working with your office with the goal of limiting the effect on your daily operations. Patient consent is not required for our request of medical records, as we are the payor/insurer provide services to your patients/our members. 

If you have any questions, contact Pearl Taylor, HEDIS Coordinator, at 215-991-4283 or our Provider Services Helpline at 1-888-991-9023 (Monday-Friday, 9:00 a.m. to 5:30 p.m.).