20-723 HEDIS Annual Medical Records Collection Begins December 1, 2020
Date: 10/27/20
Use DatafiedTM to collect requested data at no cost
California Health & Wellness Plan (CHWP) is included in the efforts to collect data for the Healthcare Effectiveness Data and Information Set (HEDIS®) Measurement Year 2020 Clinical Effectiveness of Care measures. HEDIS is a standard set of nationally reported measures used to assess the quality of care given to members.
Randomly selected participating providers will be contacted for medical records starting December 1, 2020, to May 7, 2021. Based on a provision in their contract, participating providers must submit member data when requested for health care operations and quality review.
Datafied simplifies record collection
Datafied has been contracted to retrieve the requested medical records. They can also help copy records for high-volume provider sites. If a provider office chooses to use a different copy service vendor, it is at their own expense.
Your contact information will be confirmed by telephone before the HEDIS packet is sent. A list of members with the specific data needed will be in the packet.
Send records within five days
When contacted, providers are responsible for ensuring the records are released within five days.
- If unable to do so, contact Datafied at 1-714-666-0951 with a time frame when they will be sent. Contact information is included in the packet.
- If records are not available, or the member was not your established patient during the requested time frame –
- Complete a Certificate of No Record (CNR) included in the packet. Return the CNR to Datafied or
- Contact Datafied at 1-714-666-0951 right away so the request can be redirected.
- Datafied will continue to follow up with your office for requests that are not resolved.
Precautions during COVID–19
Option for providers with Electronic Medical Records (EMR)
- To reduce the amount of vendors’ face-to-face time in your office, please contact Datafied to set up remote off-site retrieval prior to December 1, 2020. To learn more about this secure, contactless option, please reach out directly to Datafied at 1-714-666-0951.
Privacy notice
Datafied maintains the confidentiality of your patients’ protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy regulations.1 Records are only accessed by authorized persons to comply with these safeguards.2
Contact the HEDIS team
If you have specific concerns or questions related to the requested medical records or how or where to send the data, contact the Health Net HEDIS team at:
- Phone 1-800-640-3545
- The phone number is for incoming messages only
- Calls will be returned within one business day.
- Email the HEDIS team
- The email address is not secured
- Do not submit protected health information (PHI) data to this address.
Additional information
Providers are encouraged to access CHWP’s provider portal online at www.CAHealthWellness.com for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.
If you have questions regarding the information contained in this update, contact CHWP at 1-877-658-0305.
1Title 45 Code of Federal Regulations (CFR) §164.506 indicates that the routine authorization form you obtain from your patient is sufficient for disclosures to carry out health care operations. 45 CFR §164.501 defines health care operations to include quality assessment and improvement activities. Datafied follows HIPAA regulations and has procedures to protect the privacy of health information received.
2Providing medical records to Datafied follows all federal and state regulations to safeguard PHI and confidentiality.