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HEDIS Vocab words

Across
low income/disabled; federally mandated, state funded program
market type (HMO/PPO)
statement that ensures validity of a report/document
transaction data used to identify the eligible population and numberator
data release governance
a review of performance based on previous calendar year
state/area represented
a chase not able to be collected, held in que (closed)
removing a member from HEDIS measure (either mandatory/optional)
potential exclusion
reviewing medical records to obtain info for the measure
comparitive market & analysis reporting tool database
health effectiveness data & information set
total information management
national, state, regional averages
medical record review
integrated service exp tool, claims based
any healthcare professional
Down
subset/sampling of members in eligible population for the measure
value set directory, lists of value & codes for HEDIS measure
vendor inter-rater reliability
evaluation process
investigation of procedures & ops
tolerance for error, set by NCQA
total # of mbrs who meet criteria
federal government healthcare for 65 yr olds
paid for by employers/individuals
pursuit of medical record
centers for medicare/medicaid services
Health Insurance Portability & Accountability Act
corrective action plan
strategic business partner