Medical Record Research
Peer Review, HEDIS, PQRS, CINA
Direct Difference has been leading the way in Core Measures and Data Abstraction services since 1998. No one has been on the job longer than us. No company has more experience than us. When it comes to medical record research, we’ve lead the way for accuracy in reporting including comprehensive reviews, specific element review, CINA, and other procedural hot spots.
A key component for this activity is the Healthcare Effectiveness Data and Information Set (HEDIS), a tool used by most of the health plans in the U.S. HEDIS set performance metrics for important dimensions of patient care and service. HEDIS consists of 81 measures across 5 domains of care – very broad range of data that makes it possible to compare patient outcomes and efficiencies for health care policies and providers.
Direct Difference also monitors PQRS (Physician Quality Reporting System), CINA (Cardiac Intervention Necessity Assessment), and data:
- Peer Review
- Comprehensive Review
- Specific Element Review
- Radiology Advanced
- Cardiac Imaging
You’ll find a difference in our medical research protocol. We can work with your HEDIS team to collect member records and conduct reviews of these records by contacting providers and placing the results collected into a specific data base. We’ll also help you generate the necessary medical record reviews conducted on site. We’ll provide training and guidelines for the high volume interaction, follow-up and research documentation upkeep. Your staff will also benefit from our knowledge of analysis methodologies, familiarity with CPT4 and ICD10 codes based on HEDIS technical specifications.