HEDIS Compliance Audit™

To learn more, contact:
Jeff Wussow
Business Development Manager
1-800-362-2320 or 1-608-274-1940, ext. 8264

MetaStar’s HEDIS Compliance Audit Services

MetaStar provides Healthcare Effectiveness Data and Information Set (HEDIS®) Compliance Audit services for health plans. We work with commercial health plans, Medicare, Medicare Special Needs Plans (SNP), Marketplace, Health Insurance Exchanges, and Medicaid. Our experienced auditors are accessible and quick to respond throughout the audit process.

MetaStar was among the first organizations licensed in 1998 by the National Committee for Quality Assurance (NCQA) to provide HEDIS Compliance Audit services. MetaStar is NCQA compliant without any corrective actions. We have met 100 percent of all audit deliverables.

Our breadth of experience

In addition to our work as an NCQA Licensed Organization (LO) for HEDIS, MetaStar:

  • Provides Medicare Part C and Part D Data Validation contractor since audit inception in 2011.
  • Represents Wisconsin in the Lake Superior Quality Improvement Network (Lake Superior QIN), serving as the local change agent to help the Centers for Medicare & Medicaid Services (CMS) achieve national health care quality goals. MetaStar has served in similar roles for Wisconsin for more than 40 years.
  • Serves as the External Quality Review Organization (EQRO), continually contracted to the State of Wisconsin Department of Health Services for more than 30 years.
  • Serves as the Minnesota Department of Human Services performance measure validation firm since 2005.

Our audit philosophy: Quality with accuracy

As a quality improvement organization, we bring a focus on quality to all of our work. We approach each audit in a collaborative and educational manner.

What makes our HEDIS Compliance Audit service unique?

  • Our customer portal, MyMetaStar, provides a one-stop-shop approach for easy and secure communication and file sharing.
  • MetaStar’s HEDIS audit services team includes certified auditors, registered nurses, coding specialists, and dedicated IT staff. Many team members are Certified Professionals in Healthcare Quality (CPHQ).
  • MetaStar auditors provide quick responses to customer requests and provide actionable feedback for improvement.
  • As an NCQA LO, Metastar is compliant without corrective actions.
  • Our lead auditor serves on a panel for NCQA, offering insight and expertise.
  • MetaStar is a non-profit organization and has been focused on health care quality for more than 40 years.
  • MetaStar is based in Madison, Wisconsin.

What our customers say:

“Working with MetaStar is a pleasure. Everyone is very knowledgeable, their service outstanding, and they are with you every step of the way. We are a better organization because of them.” – HEDIS Compliance Audit Customer in 2016

Request a proposal

For more information, or to request a proposal from MetaStar, click here.

 

MetaStar also provides Medicare Part C and Part D Data Validation Audit services and Initial Validation Audit services.

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