HEDIS® Compliance Audit™ and Support

Advent’s expertise with HEDIS® and other NCQA governed audits and our innovative audit processes enable health plan clients to report the best, most accurate rates with increased efficiency and decreased burden.

Advent's HEDIS® audit team includes 12 Certified HEDIS Compliance Auditors (CHCA) who are fulltime Advent employees

More than 90% of health plans in the United States use the Health Effectiveness Data and Information Set (HEDIS®) to objectively measure performance across a wide range of important healthcare interventions and outcomes, and report HEDIS®, data to the National Committee for Quality Assurance (NCQA) to continuously improve and demonstrate the quality of care they provide.

The NCQA requires health plans to validate HEDIS®, data by retaining an independent, NCQA-Licensed Compliance Audit Organization and Certified HEDIS®, Compliance Auditors (CHCA) to perform the HEDIS® Compliance Audit™ standardized methodology.

With 12 certified auditors on staff, Advent Advisory Group is an industry leader in HEDIS®, compliance audits. Advent’s blend of skilled professionals are highly experienced and seasoned professional staff with at least 15 years of experience and most with over 25 years of healthcare experience.

Client Testimonial

“Our HEDIS lead auditor continues to push us up in improving our data and review processes. She brings to light measures that show questionable rates and it has always been very helpful as it gets us to explore and clean up our data collection process.”

Long Term Services and Supports (LTSS) Audit Experience

Members of our HEDIS® team have extensive experience with Long Term Care (LTC) organizations and Managed Long Term Services and Supports (MLTSS) plans. Our experience includes State Medicaid program audits, clinical file reviews, performance measure validation, and HEDIS® audits. Our knowledge of long term care programs coupled with our proficiency in working with organizations that are new to reporting make us a great partner to work with to meet State Medicaid and CMS reporting requirements.

NCQA recently announced an opportunity for MLTSS health plans to participate in a six-month learning collaborative.  The collaborative will provide numerous benefits including support with HEDIS® 2019 Technical Specifications for the Long-Term Services and Supports Measures that are new this year. To learn more about the Learning Collaborative see: NCQA LTSS Learning Collaborative Info Sheet

Additional NCQA and CMS resources regarding LTSS accreditation and reporting include: