Skip to main content

Quality

Wellcare By ‘Ohana Health Plan Quality Improvement (QI) Program monitors and evaluates the quality, appropriateness, accessibility and availability of health care services.

Medical Records

QI may conduct annual medical record audits in physician offices. Patient records are reviewed for evidence that care and screenings have been documented. Complete information is available in the Medicare Advantage Provider manuals.

Clinical Practice Guidelines

Clinical Practice Guidelines (CPGs) outline medical standards of care and best practices.

HEDIS®*

HEDIS® is a mandatory process that occurs annually. We've developed this toolkit to help identify required preventive services.

New: HEDIS Measurement Year 2022 Toolkit

HEDIS® Measurement Year 2022

HEDIS® Measurement Year 2022

HEDIS® Measurement Year 2022

HEDIS® Measurement Year 2022

HEDIS Measurement Year 2021 Toolkit

HEDIS®

HEDIS®

HEDIS®

Other Resources

The National Benchmark to measure the Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET)

Examples of Centers for Medicare and Medicaid Services Star measures which use statin therapy to evaluate health plans.

Program Announcement

Unlock the Benefits of Partnership!

Thông Tin Hữu Ích

EPSTD Program

Sign in to our secure Provider Portal to find out which eligible members are due for EPSDT screenings. If you haven’t registered on our site, please join today. Preventive pediatric health care guidelines for children are located in our clinical practice guidelines.

Provider Participation

Network providers are contractually required to cooperate with quality improvement activities. Providers are also invited to volunteer for the QI Program. Please liên hệ với chúng tôi if you’re interested in volunteering.

  • EPSTD Program

    EPSTD Program

    Sign in to our secure Provider Portal to find out which eligible members are due for EPSDT screenings. If you haven’t registered on our site, please join today. Preventive pediatric health care guidelines for children are located in our clinical practice guidelines.

  • Provider Participation

    Provider Participation

    Network providers are contractually required to cooperate with quality improvement activities. Providers are also invited to volunteer for the QI Program. Please liên hệ với chúng tôi if you’re interested in volunteering.

Liên H Vi Chúng Tôi

Cần trợ giúp? Chúng tôi luôn sẵn sàng hỗ trợ.

Liên Hệ Với Chúng Tôi
Y0020_WCM_87476E Last Updated On: 5/4/2023