Chuyển đến nội dung chính

Quality

WellCare of North Carolina wants to ensure that our members have access to quality, cost-effective health care solutions. Our Quality Improvement (QI) program aims to improve patient safety and care so our members can enhance their quality of life by staying healthy or managing their chronic health problems.

HEDIS®

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

To identify and close gaps in members’ health care, log in to the provider portal and access HEDIS Online Tools. If you don’t have an account, you can register online.

New: HEDIS Measurement Year 2021 Toolkit

HEDIS® MY 2021 Quick Reference Guide

HEDIS® MY 2021 Adult Pocket Guide

HEDIS® MY 2021 Pediatric Pocket Guide

HEDIS® MY 2021 Preventative Health Form

HEDIS Measurement Year 2020 Toolkit

This easy-to-use HEDIS® At-A-Glance Guide gives you the tools to meet, document and code HEDIS Measures.

Coordination of Care requires proactively identifying the patient’s needs, organizing care and communicating vital information at the right time to the right people.

HEDIS® Guide Adult Quick Tips

HEDIS® Adult Resource Guide

2019 HEDIS® AT-A-GLANCE: KEY BEHAVIORAL MEASURES (17 Years and Younger)

2019 HEDIS® AT-A-GLANCE: KEY BEHAVIORAL MEASURES (18 Years and Older)

Consumer Assessment of Healthcare Providers and Systems/Child CAHPS® Provider Quick Reference Guide

Every year CMS or NCQA may ask your patient the following questions. How do you rate?

Important Information on CPT II and HCPCS Codes

KEY PEDIATRIC MEASURES

HEDIS® Guide Pediatric Quick Tips

HEDIS® Pediatric and Behavioral Health Measures

Preventive Health Counseling and Education for Children and Adolescents Ages 3–17 Years

Pediatric Well-Visit Sick-Visit Form

This guide alerts you to important women's preventive care and services.

Additional Information

Medical Records Audits

Quality Improvement (QI) may conduct annual medical record audits in physician offices. Patient records are reviewed for evidence that care and screenings have been documented. 


Quality Improvement Participation

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

  • Medical Records

    Medical Records Audits

    Quality Improvement (QI) may conduct annual medical record audits in physician offices. Patient records are reviewed for evidence that care and screenings have been documented. 


  • Provider Participation

    Quality Improvement Participation

    Network providers are contractually required to cooperate with quality improvement activities. Providers are also invited to volunteer for the Quality Improvement (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
Được Cập Nhật Lần Cuối Vào: 132/1/2020