FAQ Directory: HEDIS

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9.15.2022 Follow-Up After Emergency Department Visit for Substance Use (FUA) Should the Residential Program Detoxification Value Set be used when reporting the FUA measure? It is not listed in the Value Set Directory.

Yes. The Residential Program Detoxification Value Set and codes will be included in the Update release of the Value Set Directory on March 31, 2023. The OID for the value set is 2.16.840.1.113883.3.464.1004.2408, and it includes two HCPCS codes:

  • H0010     Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) (H0010)
  • H0011   Alcohol and/or drug services; acute detoxification (residential addiction program inpatient) (H0011)

HEDIS MY 2023

9.15.2022 Quality Compass Exchange Product Does NCQA have Exchange data available on Quality Compass?

In 2022, NCQA will be releasing  Quality Compass Exchange data for the first time. Exchange data will be available outside of the Quality Compass tool via a data file delivered on NCQA’s Download Center. The data file will contain individual plan level performance and benchmarks (averages and percentiles) for Exchange plans. It will contain results for QRS measure indicators used in the QRS Scoring program only. The Exchange data file is available for purchase now and will be released in November 2022.
 

HEDIS MY 2021

9.15.2022 Quality Compass License Agreement How can we determine if the Quality Compass license agreement meets my needs?

The standard license agreement for Quality Compass allows internal or external reporting for 15 measure indicators, 20 health plan submissions and 2 benchmarks (averages and/or percentiles) outside of the users licensed on the account. If your organization’s expected data usage does not align with the standard agreement, we can review your requested permissions and draft a customized agreement, subject to a different fee structure.
 

HEDIS MY 2021

9.15.2022 Antibiotic Utilization for Respiratory Conditions (AXR) The Antibiotic Utilization for Respiratory Conditions (AXR) does not include age stratifications and total rate bullets. Was this intentional?

No. A correction will be in the MY 2023 Technical Update. The Ages section in the Eligible Population should read as follows:
Members who were 3 months of age or older as of the Episode Date. Report three age stratifications and a total rate:

  • 3 months–17 years.
  • 18–64 years.
  • 65 years and older.
  • Total.

The total is the sum of the age stratifications.

HEDIS MY 2023

9.15.2022 Publicly Reported Plans in Quality Compass How do I know what plans publicly reported data to NCQA? How do I know what measures will be reported in Quality Compass?

To obtain a list of health plan submissions and/or measures publicly reported in Quality Compass for a specific reporting year, contact the Information Products team by submitting your question on my.ncqa.org.
Quality Compass contains HEDIS and CAHPS measures that were eligible for publicly reporting during the measurement year. First year HEDIS measure results are not publicly reported in the tool.
 

HEDIS MY 2022

9.15.2022 Cost to Purchase Quality Compass How much does Quality Compass cost?

Quality Compass is priced according to the number of users, years of trended data, and whether your organization needs access to the Data Exporter feature. The cost breakdown is available on our pricing table on the NCQA Store .
 

HEDIS MY 2021

9.15.2022 Purchasing Quality Compass How do I purchase Quality Compass?

If you are purchasing Quality Compass directly from the NCQA Store and your organization does not require a custom license agreement, you can simply visit the NCQA Store page to complete your purchase.
If you require a custom data license agreement and have accepted the quote provided by the Information Products (IP) team, the next step is to have a customized agreement forwarded to you for the organization’s review and signature. The customized agreement will include information on the permissions, data usage and fees discussed with the IP department.

Once the agreement is signed by both parties, NCQA will issue an invoice for payment. Once payment is received, you will be granted access to the data and/or the agreed upon permissions take effect.
 

HEDIS MY 2021

9.15.2022 Audit Timeline The HEDIS MY 2022 Audit Timeline posted on NCQA’s website states that organizations must submit all documentation, including Sections 5 and 5a of the Roadmap, by March 1. Does this mean that organizations have until March 1 to submit Sections 5 and 5a?

No. The Roadmap is due January 31. All sections must be submitted by this date. The “March 1” date for Sections 5 and 5a is meant to account for the rare occasion where a supplemental data source is identified after the January 31 deadline and must be considered for audit. These sources must be identified no later than March 1, with a completed Roadmap section. This should be the exception, not the standard process.

HEDIS MY 2022

9.15.2022 Quality Compass Access When will I receive access to Quality Compass?

Access to the data is granted as soon as payment is received by check or credit card.

The default email address used for access will be the individual’s whose information was included under the “Ship To” section completed at checkout Login and password information will be emailed to the default user after NCQA sets up the account. The default user, also known as the Administrative User, will have access to manage the additional licensed users on the account.

 

HEDIS MY 2021

9.15.2022 Invoice for Quality Compass How do I obtain an invoice to purchase Quality Compass?

If your organization needs an invoice prior to placing your order for Quality Compass, please reach out to our Information Products team by submitting a case through your my.NCQA.org account.
 

HEDIS MY 2021

9.15.2022 Quality Compass Data Comparison Across All Product Lines Is there a way to compare the data across product lines?

Currently each license is separated and there is no way to compare Commercial, Medicaid and Medicare in the same license. However, with the Data Exporter function, you will be able to pull reports in Microsoft Excel and that can make data comparison easier.
 

HEDIS MY 2021

9.15.2022 Oral Evaluation, Dental Services (OED) The OED measure references the NUCC Provider Taxonomy Value Set to identify dental providers. Is this correct?

No. Replace “NUCC Provider Taxonomy Value Set” with “Dental Provider Value Set.” This correction will be in the MY 2023 Technical Update.

HEDIS MY 2023