HEDIS Compliance

The challenge is to automate the process of the insurance company's yearly audit of Committee on Quality Assurance. The scope included tuning the performance of the several measures on Oracle Data warehouse. Hedis is a set of performance measures that the auditor uses to rate the insurance company's health insurance plans. The performance measures are in the nature of ratios that are arrived at after running the reports against the data in the data warehouse. The various performance measures included:

Antidepressant Management Check Ups after Delivery Prenatal Care in First Trimester Cervical cancer Screening Breast cancer screening Adolescent Immunization Child Hood Immunization Child access to PCP Adult Access to Preventive/Ambulatory Service Well Care (Adolescent) Well Care Visits (3 - 6) Well-Care Visits (15 Month)