Quality Improvement Tip Sheets

We collect quality data from providers to measure and improve the care our members receive. Our tip sheets can help you satisfy quality measures. These include Healthcare Effectiveness Data and Information Set (HEDIS®) measures from the National Committee for Quality Assurance and National Quality Forum measures.

Complying with these measures may reduce the need for you to provide medical records later for review.

Note: The tip sheets below do not have diagnosis and procedure codes. Providers can access tip sheets which include common diagnosis and procedure codes on Availity ® Essentials

  1. Sign into Availity® Essentials
  2. Navigate to Payer Spaces
  3. On the Resources tab select Quality Improvement Tip Sheets to open and locate the Tip Sheet

Medical Tip Sheets

Behavioral Health HEDIS Tip Sheets

 

HEDIS is a registered trademark of NCQA. Use of this resource is subject to NCQA’s copyright, found here. The NCQA HEDIS measure specification has been adjusted pursuant to NCQA’s Rules for Allowable Adjustments of HEDIS. The adjusted measure specification may be used only for quality improvement purposes.

* Measurement Year (MY) 2020 and MY 2021

The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment.

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.