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Quality – HEDIS/NCQA Updates for Providers, Winter 2019

Oct 30, 2019
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Important information on the Risk Adjustment program

Risk Adjustment Update

Closing gaps in care for Members identified with potential high-risk conditions is part of our ongoing Risk Adjustment efforts. This work includes outreach to targeted Members to encourage them to see their PCP before the end of 2019 and sending Gap Closure Forms to relevant providers. If your office receives these forms, please complete and return them as soon as possible following the office visit.

This year Health Options has partnered with Datafied to assist with Risk Adjustment medical record retrieval. If your office is contacted, you will be asked to send medical records as instructed on the request form. If you have already sent your records, thank you for your cooperation.

If you have any questions regarding Risk Adjustment, please reach out to Deidre DeRoche, Manager, Government Programs at dderoche@healthoptions.org.

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Feel free to include the following information in your own newsletters.

As confirmed cases of COVID-19 continue to be reported, you may be wondering what you can do to avoid exposure to the virus. Until a vaccine is developed, healthcare authorities recommend following the same steps you would take to prevent the spread of other respiratory viruses. That includes:

  • cleaning your hands regularly and thoroughly with an alcohol-based hand rub or washing them with soap and water.
  • Maintaining at least three feet of distance between yourself and anyone who is coughing or sneezing.
  • Refraining from touching your eyes, nose and mouth, where the virus can be transmitted into your body.
  • covering your mouth and nose with your bent elbow or tissue when you cough or sneeze, then disposing of the used tissue immediately.

To avoid misinformation about COVID-19, look to trustworthy sources, such as the CDC, the World Health Organization, and local health departments websites to stay informed.