Individuals. Families. Doctors. Insurance companies. Many different people are interested in the quality of America’s health care plans. The Healthcare Effectiveness Data and Information Set (HEDIS) gives you the answers you are seeking. How good are different plans in providing preventative care? What about treatment options? And how many do it so well that customers feel satisfied about their overall experience? Do these plans offer great physician and hospital choices? What Is HEDIS? HEDIS is a tool for better understanding health care plans. Created by the National Committee for Quality Assurance (NCQA), HEDIS has a standardized set of performance measures that show the different health plans’ levels of service and care toward members. There are 81 performance measures broken down into 5 large care domains. Here are some examples of HEDIS [...]
You Have Great Vision! Do You Still Need An Eye Exam? You’ve never had to wear glasses. You pride yourself on reading the small print from yards away. You are basically a vision master. So you probably think you don’t need to go to your optometrist, right? After all, aren’t doctors for sick people? The truth is no matter how amazing your vision is, you still need to see your eye care professional. Here’s why: Vision Isn’t The Only Thing Worth Checking You don’t only visit a dermatologist to deal with wrinkles. You don’t only visit a gynecologist to see if you can have a baby. And you don’t only visit your dentist to have whiter teeth. The reason we visit specialists is to ensure we are wholly healthy. How [...]
iCare Wins Aetna 5 Star HEDIS Quality Provider Award for Superior Outreach Services iCare Health Solutions has been honored with the Aetna 2017 Five Star HEDIS Quality Provider award. iCare, based in South Florida, has partnered with Aetna since 2013, providing optometric, medical eye care, and Healthcare Effectiveness Data and Information Set (HEDIS) services in the state of Florida. iCare’s Retinal In5ights HEDIS program provides customized solutions to assist health plans and medical groups in closing their non-compliant diabetic retinal exam (DRE) HEDIS care gap metric. The 5 Star HEDIS Quality Provider award was presented to iCare Health Solutions at the Aetna Vendor Expo. The expo's purpose was to train and educate companies on upcoming Medicare benefits. This highly exclusive award recognizes vendors for obtaining the “gold standard” in performance. [...]
iCare Brings More Diabetic Retinal Exams to You During the next few months you may notice an increase in call volume and diabetic retinal exam appointments. Here's why: iCare Health Solutions is currently conducting Interactive Voice Response (IVR) and live agent outreach to contracted insurance companies who have diabetic members that are non-compliant for having their diabetic retinal exams. These members may be scheduling an appointment with you directly as a result of messaging they’ve received from their insurance company, primary care physician, or from us. They may also be transferred from an iCare Call Center representative to your receptionist for scheduling. Why is there an increased need for diabetic retinal exams? It all comes down to HEDIS. Healthcare Effectiveness Data and Information Set (HEDIS) is something you should be [...]
HEDIS Patient Chart Requirements Our health plan partners have updated their data requirements for HEDIS reporting, affecting all doctors. Therefore, we have listed below the updated patient chart requirements for documented Diabetic Retinal Examinations (DRE). Please ensure to include all information in your clinical notes for proper documentation of the service. (2) Member identifiers such as Member name and date of birth; or health plan identification number Name of provider performing the eye exam Provider credentials (MD, OD, DO) Provider signature Digitally signed documents are acceptable If not digitally signed, in addition to the signature there should be a legible printed name of the practitioner Type I Diabetes – Yes or No (E10.9 for type 1 with no retinopathy) Type II Diabetes – Yes or No (E11.9 for type 2 [...]
The Diabetic Retinal Exam Screening Technician in Miami will be responsible for providing Retinal Screenings for non-compliant Diabetic patients.