Reminder: HEDIS MY2023 Medical Record Requests

Each year, the National Committee for Quality Assurance (NCQA) measures the clinical quality performance of health plans across the nation through a standardized set of quality measures. This measure set — known as the Healthcare Effectiveness Data and Information Set (HEDIS®) — evaluates important dimensions of care and service including 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 NCQA and CMS, CarePartners of Connecticut will send HEDIS MY2023 medical record requests via mail to providers beginning in February 2024. 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.

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. You can be assured that our staff will maintain confidentiality of all medical information as required by HIPAA regulations.

Providers must electronically submit the necessary information to the Provider Quality Performance Department via fax at 617-67-.0754 or secure email at HEDIS@point32health.org by Feb. 28, 2024. For questions, contact the Provider Quality Performance HEDIS Help Line at 888-766-9818, option 1, 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.

On CarePartners of Connecticut’s HEDIS Tip Sheets for Your Practice page, you can find a number of tip sheets we’ve developed to offer insight into specific measures and aid your practice in optimizing performance, as well as this tip sheet presentation providing information pertaining to HEDIS hybrid measures that require medical record review each year.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).