Providers

23-1213m Annual Medical Records Collection Begins January 1, 2024

October 16, 2023 

Use DatafiedTM to collect requested data at no cost

Wellcare is collecting data for the Healthcare Effectiveness Data and Information Set (HEDIS) Measurement Year 2023 Clinical Effectiveness of Care measures. HEDIS is a standard set of nationally reported measures used to assess the quality of care given to members.

Physicians and independent practice associations (IPAs) will be randomly contacted for medical records from January 1, 2024, to May 3, 2024. Based on a provision in their contract, physicians and IPAs must submit member data when requested for health care operations and quality review.

Datafied simplifies record collection

Datafied has been contracted to retrieve the requested medical records. They can also help copy records for high-volume provider sites. If a physician or IPA chooses to use a different copy service vendor, it is at their own expense. 

Your contact information will be confirmed by telephone before the HEDIS packet is sent. The packet will include a list of members and specific data needed.

Send records within seven days

When contacted, you must ensure the records are released within seven days.

• If unable to do so, contact Datafied at 714-666-0951 with a time frame when they will be sent. Contact information is included in the packet.

• If records are not available, or the member was not your established patient during the requested time frame, physicians and IPAs must:

- Confirm that they do not see the patient(s) at other locations. If they do, the physician or IPA must indicate this                       on the Certificate of No Record (CNR) or let the Datafied contact know.

- Complete the CNR included in the packet. Return the CNR to Datafied, or

- Contact Datafied at 714-666-0951 right away so the request can be redirected.

• Datafied will follow up with your office for requests that are not resolved.

Privacy notice

Datafied maintains the confidentiality of your patients’ protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy regulations.1 Records are only accessed by authorized persons to comply with these safeguards.²

Contact the HEDIS team

If you have specific concerns or questions related to the requested medical records or how or where to send the data, contact the Health Net HEDIS team at:

Additional information

If you have questions regarding the information contained in this update, contact 866 999 3945.

¹Title 45 Code of Federal Regulations (CFR) §164.506 indicates that the routine authorization form you obtain from your patient is sufficient for disclosures to carry out health care operations. 45 CFR §164.501 defines health care operations to include quality assessment and improvement activities. Datafied follows HIPAA regulations and has procedures to protect the privacy of health information received

²Providing medical records to Datafied follows all federal and state regulations to safeguard PHI and confidentiality.