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The Solution - NCQA Certified Software (PDF)

Powerful, web-based, NCQA Certified Software to help you manage your complete HEDIS® reporting and workflow processes. We’ve raised the bar with exceptional standards of security, reliability and availability. We initiate HEDIS projects by assessing your operational and technical environment.

With this powerful Software as a Service (Saas) solution, APS delivers end-to-end HEDIS Reporting with proven capabilities that extend far beyond compliance basics. APS’s Solution is an easy-to-use system to manage and streamline HEDIS reporting processes. Used by a diverse range of clients, it raises the bar with exceptional standards of security, reliability and availability.

APS does the prep work. We prepare clients for HEDIS projects with our HEDIS Exploratory and Prepatory Tool™ to assemble the background information we’ll need to understand your operational and technical environment. We proactively identify and resolve issues that could impede the process and potentially lower your rates.

And APS does the follow up work. We work closely with your NCQA auditor and provide all necessary documentation, including vendor portions of the Road Map. APS also creates the Medicare Patient Level Data files and completes the NCQA IDSS tool.

In addition to the required HEDIS reporting components, APS offers practical Intervention Tools to optimize your rates during the year. These include:

  • Provider Intervention Letters: Target selected members requiring specific HEDIS services for subsequent year’s HEDIS measures.
  • Provider Report Cards: HEDIS Rate Reports that can drive ongoing Quality Improvement and foster improved communications with specific Providers.

The Solution includes several powerful, productivity-boosting components:

DUET™ - Data Upload Execution Tool

DUET is web-based software that maps, uploads and evaluates your source data. It monitors HEDIS data collection progress and produces automated data integrity reports – robust assessments of uploaded HEDIS data quality data – for each data set. It’s fundamental to getting projects underway quickly and with confidence.

HEDISLinx™ Analysis and Reporting

HEDISLinx is a secure, online portal with tools that provide analysts, managers and executives real-time access to Measures, Metrics, Rates and comparisons to plan norms to identify and remedy issues long before audit processes commence.
HEDISLinx reports your HEDIS results for each product line (Medicare, Medicare Special Needs Plans, Medicaid, Commercial HMO and PPO, etc.) and allows you to:

  • View and analyze rates with benchmarks and reasonability checks for key measures.
  • Built-in checks alert you to examine questionable rates before your does.
  • Member level detail to assess denominator and numerator qualifying events.
  • Produce premier Provider Report Cards with graphs that compare individual providers and networks to the plan-wide average as well as against target rates.

RISE™ – Rate Improvement System and Evaluation

The optional RISE module is a specialized intervention process for systematically implementing rate improvement strategies. RISE targets opportunities to proactively improve your rates, and features HEDIS rate reporting over different time periods, including rolling monthly and quarterly reports.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).