HEDIS® Compliance Audit™

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

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. We have, and continue to meet 100 percent of all audit deliverables.

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, typically within one business day, to customer requests and provide actionable feedback for improvement.
  • As an NCQA Licensed Organization, Metastar is compliant without corrective actions from NCQA.
  • 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.

Our breadth of experience

In addition to our work as an NCQA Licensed Organization for HEDIS, licensed organization, MetaStar has been:

  • A Medicare Part C and Part D Data Validation contractor since audit inception in 2011.
  • A Quality Improvement Organization (QIO), contracted to the Centers for Medicare & Medicaid Services (CMS) for 40 years, now representing Wisconsin in the Lake Superior Quality Innovation Network.
  • An External Quality Review Organization (EQRO), continually contracted to the State of Wisconsin Department of Health Services for more than 30 years.
  • The State of Minnesota Department of Human Services performance measure validation firm since 2005.
  • The State of Maryland Department of Health and Mental Hygiene Medicaid HEDIS audit firm starting in 2016.
  • Commercial Risk Adjusted Initial Validation Audit Entity since 2015.
  • A URAC Accreditation Validation organization since 2017.

What our customers say:

“MetaStar is timely and thorough in services, always quick to answer questions and concerns, and professional in their approach. We’ve found the audit process to be very well organized, customized to our needs, thorough and with an emphasis in helping us to improve to be the best we can be.” – HEDIS® Compliance Audit™ Customer in 2017

Request a HEDIS Compliance Audit 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, Initial Validation Audit, and URAC Accreditation Validation Audit services.

MetaStar’s HITRUST Certification is pending.

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).

Licensed as a NCQA Compliance Audit Organization - 2017