SERVICES OVERVIEW

Medisys has a proven track record in meeting the supplemental staffing needs of a wide variety of clients - insurers, managed care systems, hospitals, and other health care providers. Our nurses are available to assist in the full range of medical management services including:

  • Medical Record Review (MRR)
  • Pre HEDIS® and HEDIS® Medical Record Review
  • Physician Credentialing and MRR
  • Quality Management

MEDISYS is your comprehensive source for consulting and data collection for quality measurement and improvement. MEDISYS utilizes the latest national treatment guidelines, NCQA and HEDIS® requirements and other quality standards to conduct medical record reviews, analyze practice data, and provide reliable clinical outcomes information. As an independant third party, we work for you and ensure client confidentiality. Whether you represent an indemnity insurer, managed care organization, provider network, healthcare delivery system or agency, or public insurance company, our services can be customized to meet your quality managment needs.

Medisys has extensive experience in managing HEDIS® and other medical record review (MRR) projects. Our Project Managers are seasoned clinicians with expertise in HEDIS® measurements, NCQA specifications and guidlines as well as various MRR project criteria and guidelines. We have a proven track record for successfully organizing, coordinating, and completing data collection in compliance with NCQA and State specific guidelines and timeframes.

Medisys has extensive experience with managing State specific MRR projects. Our Project Managers are experts in State specific guidelines and criteria.

Medisys has a 100% pass rate for all audits we have participated in over the past 15 years. Our Project Managers know how to successfully manage a project and prepare records for audits with positive outcomes.

Our services include:

  • HEDIS® data collection tool development and evaluation
  • HEDIS® training program development and implementation
  • HEDIS® training manual development and evaluation
  • Guidelines development and formatting
  • Audit and survey tool development and pilot testing
  • Record review and other data collection, entry and analysis
  • Preparation of comprehensive audit feedback reports
  • Corrective action plan development, implementation, and evaluation
  • Documentation of study findings
  • Development and documentation of a QA program

Medisys has a trademarked HEDIS® training program which includes our copyrighted HEDIS® training manual for each attendee. Topics covered in the two day program cover all aspects of a MRR project, to include all HEDIS® measures and NCQA specifications, reviewer responsibilities, hands-on practice charts, investigative principles when needed, ie chasing, quality abstraction and measurement, as well as any software training necessary.

One of the many strengths offered by the staffing resources of MEDISYS is the ability to provide nurses to complete large-scale data collection projects quickly, in a high-quality manner.

Examples of this type of activity includes HEDIS® measurement, research data collection from charts, and medical record reviews to support credentialing.

We screen all nurses carefully, and maintain records of qualifications and professional and competent manner.

Whether you represent an indemnity insurer, managed care organization, provider, network, healthcare delivery system or agency, or public insurance program, our services can be customized to meet your quality management needs.