HEDIS Auditing
Compliance Audits P4P Audit Reviews
WHP Reviews
 
CMS Part C & D
Data Validation
HIPAA 5010 Compliance - EDS Transition
Healthier Days
Data Consulting
Research Consulting
Survey Services

Audit Timeline

Below is a typical timeline based on a June submission of HEDIS results to NCQA or a state agency.

  • Contract with client finalized by November

  • Baseline Assessment Tool is sent to health plan by mid-November

  • Onsite visit dates confirmed and tentative agenda outlined in December

  • BAT is completed and returned 6 to 8 weeks prior to the site visit

  • Conference call is placed to confirm site visit and discuss outstanding issues 3 weeks prior to site visit

  • Onsite audit visit scheduled for the February-April period

  • Follow-up report sent 10 working days after the site visit

  • All actions required from onsite audit completed by May 15 or June 1, based on reporting requirements and line of business

  • Interactive Data Submission System (IDSS) made available to the auditor for verification of calculations no later than June 1 or June 15, based on reporting requirements and line of business

  • Auditors verify measure rates, issue final measure determinations, lock the IDSS, and approve the submission of HEDIS results to NCQA and/or state agency by June 15 or June 30, based on reporting requirements and line of business

  • Final Audit Report issued to health plan and NCQA within 30 days after Final Audit Statement is rendered and IDSS submitted to NCQA and/or state agencies
* HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
* HEDIS Compliance Audit™ is a registered trademark of the National Committee for Quality Assurance (NCQA).