We are among the largest of HEDIS® audit firms and have completed thousands of HEDIS audits since the inception of auditing in 1998. They include NCQA HEDIS Compliance Audit™, HEDIS Align. Measure. Perform. (AMP) Audit Reviews, and Wellness and Health promotion (WHP) Reviews. Our relationship with the National Committee for Quality Assurance (NCQA) is integral to our services and has been in place since NCQA was established. In addition, we have extensive HEDIS audit experience with state governmental agencies.

HEDIS® Compliance Audit™

When we complete an audit, we deliver more than just the minimum requirements and more than the required elements of the reports. In all, we deliver:

Detailed reports that contain the results of the current audit and recommendations for improved results.
Information on best practices we have gained from our experiences with others that we can share with you.
Advice on possible ways to resolve any issues or problems that may have surfaced during the audit.

Each report delivers useful information about the audit process and the status of internal processes, as well as our recommendations. We make it a point to bring you the actual information you need, not just reprints of HEDIS specification pages.

After audit season ends, the relationship continues. We maintain an email dialogue throughout the year. When we get an email or policy update from NCQA, we share it with you in a succinct monthly email format.

Even though we deliver premium service, we do not charge premium fees. We are extremely cost-competitive, and offer discounted multi-year contracts. Our contracts are written in an all-inclusive format, we will not charge incremental fees "in-season" unless we have agreed with our client to add a service. There are never any surprise fees for a la carte services.

A Typical Audit Timeline

NOVEMBER
Contract with HDC finalized; Record of Administration, Data Management, and Processes (Roadmap) is sent to client after document is released by NCQA; Audit Information Packet (AIP) is distributed to each client.
DECEMBER
Lead Auditor starts discussions with client; HDC Annual Client Conference takes place (highlights changes in HEDIS specifications and audit processes); Approval of supplemental data starts.
JANUARY
Roadmap submitted by January 31st; Ongoing dialogue with clients continues.
FEBRUARY/MARCH
Lead auditor prepares Roadmap Outstanding Items report; Onsite agenda prepared and distributed for comment; Pre-onsite conference calls start (usually 2-3 weeks before onsite date); All supplemental data must be approved by end of March.
FEBRUARY/APRIL
Onsite audit visit (typically 1-2 days.); 10 working days later HDC sends follow-up report to client; Review of programming code starts for clients not using an NCQA certified measure vendor.
MID-APRIL
NCQA makes Interactive Data Submission System (IDSS) tool available to our clients so performance scores can be reported to NCQA.
MAY
Medical Record Review Validation process starts on May 6th for any client calculating measures using the hybrid method and finishes at end of May; Client provides HDC lead auditor with interim rates for all administrative measures; HDC releases IDSS Tool to each client for performance evaluation.
JUNE
Auditor verifies rates for all reported measures and issues final approval by applying auditor lock to each IDSS submission; Client submits performance scores to NCQA or state agencies.
JULY
Final Audit Reports are issued on July 15th or within 30 days of auditor approval. As required, a Final Audit Statement for any state agency report is also issued.
* NOTE: For state-only submissions, we use a similar timeline, which is adjusted based on the submission date of the individual state agency. However, submission of the Roadmap and approval of supplemental data must follow the above deadlines. Any submission to NCQA must follow the timeline above, regardless of the individual state agency timeline.

For more information on our experience, resources and services, contact: Paul Ackroyd at 717.458.0554 ext 3003 or pjackroyd@hdcdata.com.

HEDIS® Auditing Our audits meet all standards. Our service exceeds them.

HEDIS® Compliance Audit™

A Typical Audit Timeline

HEDIS® Auditing
Our audits meet all standards.
Our service exceeds them.