BCBSTX complies with state and national demands for accountability by collecting performance data using the Healthcare Effectiveness Data and Information Set (HEDIS®). HEDIS® is the most widely used and nationally accepted effectiveness of care measurement tool available. The results are utilized to ensure that our members are getting the best healthcare possible, so it is important that our Providers understand the HEDIS® specifications and guidelines.
We want to simplify the process by including the list below of BCBSTX’s MY2021 Measures and important HEDIS® dates.
HEDIS® MY2021 BCBSTX Medicaid Measures:
|WCC||Weight Assessment and Counseling for Nutrition and physical Activity|
|CIS||Childhood Immunization Status|
|IMA||Immunizations for Adolescents|
|CBP||Controlling High Blood Pressure|
|CDC||Comprehensive Diabetes Care|
|PPC||Prenatal and Postpartum Care|
|CCS||Cervical Cancer Screening|
HEDIS® MY2021 Key Dates:
|Early February 2022||Medical Records Pull Lists faxed to Provider office|
|April 15, 2022||Deadline for Providers to submit medical records|
|April 29, 2021||Deadline for BCBSTX record abstraction|
In early February 2022, BCBSTX will contact your office to verify the medical record point of contact and provide you with necessary documents for HEDIS MY2021.
If you have any questions, please contact Diane Medders by e-mail. Please do not include Protected Health Information (PHI) in the email.
We greatly appreciate your assistance and the care you provide our members and your patients.
Reference and review the BCBSTX Preventive Care Guidelines (PCGs), Clinical Practice Guidelines (CPGs) and THSteps for Medical Providers which includes all current vaccine schedules, ImmTrac2, and other important guidance for treating your patients.
HEDIS is a registered trademark of NCQA. Use of this resource is subject to NCQA’s copyright. 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) 2021
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations, and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.