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HEDIS® Tip Sheets

Quality measures help ensure our members receive appropriate care. We created tip sheets to help you satisfy quality measures, including Healthcare Effectiveness Data and Information Set (HEDIS) measures* from the National Committee for Quality Assurance (NCQA).

Compliance with these measures may reduce the need for you to send medical records later for review. Except where noted, the tip sheets include measure requirements for all our members including, all fully-insured PPO, Blue Choice PPOSM and HMO, Blue Cross Community Health PlansSM (BCCHPSM), Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Medicare Advantage members (unless otherwise specified)

Behavioral Health

*Measurement year 2020 and 2021

HEDIS is a registered trademark of NCQA.

The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment.