Software

Compliance Reporter

A robust reporting and workflow management tool for payers and TPAs that want to streamline and increase their Healthcare Effectiveness Data and Information Set (HEDIS®) quality measurement and reporting activities.

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What’s included in Compliance Reporter

  • Systematic medical record review

    • Manage the entire medical record review process with single-source, clean data
    • Streamline chart review with web-based workflows
    •  Includes management chart review and chart chase management
    • Flexible task assignments accommodate various workflows to speed the process
    • Stay on track with HEDIS process productivity summary, which includes measure status and a tally of remaining/completed charts by reviewer
    • Validate full compliance and exclusion reports from external reviewers

  • Comprehensive NCQA-specific reporting

    • Receive up-to-the-minute results for HEDIS measures and reporting
    • In-line rate calculations and live reports
    • Benefit from the full suite of NCQA HEDIS measures, which are updated annually
    • Manage provider group, physician, and plan performance
    • Calculate financial rewards for quality and pay-for-performance metrics

Amplifyyour HEDIS activities

Compliance Reporter - businesswoman working in office at computer

Improve data integrity with a centralized data repository

Simplify the complete hybrid review process through our NCQA-certified HEDIS quality rules processing engine. Generate samples, manage medical record abstractions, and create data submission files. Plus, support medical record review activities with online data collection. A central data repository holds claims, membership, enrollments, lab, and pharmacy data, plus scanned charts.

Compliance Reporter - two colleagues working together

Streamline workflows to increase efficiency

Increase efficiency throughout the HEDIS lifecycle. Create your CAHPS® survey sample frame in a few clicks. Manage both your HEDIS and analytics drawing from the same input files with Risk Manager. Eliminate time-consuming manual coding and measure updates with automated processes. Certify final hybrid rates within minutes, rather than days.

Compliance Reporter - businessman working in office at computer

Web-based tools to get fast results

Use web-based workflows to allocate chart reviews manually or systematically by location. Compliance Reporter allows you to isolate measure-level and member-level detail for further research using powerful audit tools. Receive up-to-the-minute results with in-line rate calculation. Quickly generate NCQA IDSS data files, the CMS-required PLD submission file, and Medicare patient-level data for final submission.

Compliance Reporter - two colleagues working together

Pair with Risk Manager to increase functionality

When used with Risk Manager, Compliance Reporter provides graphical reports of overall measure performance, quality results trending, and plan/product line performance. Our software also supports full quality management lifecycle, providing robust reporting and measurement.

Our outcomes

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