CPB Certified Professional Biller Certification Practice Exam

What does HEDIS refer to in healthcare?

1. Health Education Documentation and Information Systems

2. Health Plan Employer Data and Information Set

3. Healthcare Efficiency Data and Information Set

4. Health Evaluation and Data Information Sytem

The correct answer is: Health Plan Employer Data and Information Set

HEDIS stands for Health Plan Employer Data and Information Set. It is a set of standardized performance measures developed by the National Committee for Quality Assurance (NCQA) to provide a way to evaluate the quality of care and services provided by health plans. HEDIS includes a variety of metrics that assess aspects like patient satisfaction, preventive services, and treatment outcomes, allowing consumers to compare different health plans based on various quality indicators. The use of HEDIS is vital in promoting transparency and accountability among health plans, which can lead to improved healthcare quality and better health outcomes for patients. Health plans gather data from their administrative records, member surveys, and medical records to compile the HEDIS measures, which then inform stakeholders about how plans perform in delivering care. Understanding HEDIS is essential for professionals in healthcare billing and coding, as it reflects the need for accurate documentation and reporting. By being informed about HEDIS measures, practitioners can contribute to efforts aimed at improving care quality and can assist health plans in achieving higher performance ratings.