Reminder: HEDIS MY2021 Medical Record Requests

Each year, the National Committee for Quality Assurance (NCQA) measures the clinical quality performance of health plans across the nation. The assessment in the NCQA’s standardized measurement criteria — known as the Healthcare Effectiveness Data and Information Set (HEDIS) — includes considerations such as effectiveness of patient care, access and availability of care, patient experience, and management of health conditions. The clinical components are measured using data from claims and medical record reviews.

As required by the NCQA and CMS, CarePartners of Connecticut will send HEDIS MY2021 medical record requests via mail to providers beginning in February 2022. Using a systematic process, NCQA selects a sample of providers to receive these requests. Providers should follow the submission instructions as outlined in the mailing.

We appreciate your assistance in providing us access to these records or in sending copies of the requested documentation to us for our review. You can be assured that our staff will maintain confidentiality of all medical information as required by HIPAA regulations. Your help is crucial to the project, as every medical record counts, and your prompt response will ensure that CarePartners of Connecticut’s HEDIS measures accurately represent the high quality of care you provide to our members.

CarePartners of Connecticut requires providers to electronically submit the necessary information to the Provider Quality Performance Department via fax at 617.673.0754 or secure email at HEDIS@tufts-health.com by February 28, 2022. For questions, contact the Provider Quality Performance HEDIS Help Line at 888.766.9818, ext. 52809. CarePartners of Connecticut values your continued participation with our clinical quality improvement efforts to meet regulatory and accreditation requirements for the NCQA and CMS HEDIS medical record review.