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On Feb. 21, 2024, Change Healthcare experienced a cyber security incident. Any individuals impacted by this incident will receive a letter in the mail. To learn more about this from Change Healthcare, please visit the Change Healthcare website or reach out to the contact center at 1-866-262-5342. More from Change Healthcare
On Feb. 21, 2024, Change Healthcare experienced a cyber security incident. Any individuals impacted by this incident will receive a letter in the mail. To learn more about this from Change Healthcare, please visit the Change Healthcare website or reach out to the contact center at 1-866-262-5342. More from Change Healthcare

April 2025 Provider's Corner

 

HEDIS is a set of performance measures developed by the National Committee for Quality Assurance (NCQA), which holds Buckeye accountable for the timeliness and quality of healthcare services delivered to its diverse membership. Your work to help us track and report on HEDIS measures ensures we are providing the tools and resources to help more members get and stay healthy.

Below are some of the measures we are focusing on this month:

Members ages 18–75 with diabetes (types 1 and 2) who had a retinal eye exam

HEDIS® Improvement Tips:

  • A documented note or letter in patient’s chart signed by an eye care provider indicating the ophthalmoscopic exam was completed with date and results.
  • A retinal or dilated eye exam done by an eye care professional in the measurement year.
  • Set care gap alerts in EMR as a reminder to schedule missing appointments.
  • Documented photograph in patient’s chart with date the fundus photography was performed and resulted by an eye care provider.

Members ages 18 to 85 with diabetes (type 1 and type 2) who had received a kidney health evaluation by estimated glomerular fltration rate (eGFR) and a urine albumin-creatinine ratio (uACR) during the measurement year.

HEDIS® Improvement Tips:

  • Member must receive both an eGFR and uACR test to meet compliance for the measure.
  • Encourage member to be ready to provide sample at visit check in.
  • Review medical records prior to visit and remind member to complete lab test ordered.

Children who complete all immunizations on or before child’s 2nd birthday.

HEDIS® Improvement Tips:

  • Educate office staff on the importance of scheduling appointments prior to the child reaching 15-or 30-day mark.
  • Healthchek Early and Periodic Screening, Diagnostic and Treatment (EPSDT) required services.
  • A strong recommendation for vaccination remains the most powerful for compliance with vaccination recommendations. Take time to educate members and their families about common misconceptions concerning vaccinations using easy-to-understand language and handouts.