Quality Tools

Quality Tools and Resources to Assist Your Practice

In an effort to help you and your office staff with the increasing importance and complexity of quality and risk adjustment documentation and coding, HealthCare Partners created some valuable tools.

These tools will assist you and your office staff in reaching your quality and risk adjustment documentation and coding goals while reducing time spent on administrative functions and increasing the time available for patient care.

Annual Wellness Visit Form

As you know, quality health care begins with an annual wellness visit (AWV). Use our Annual Wellness Visit (AWV) form to document your patients’ well visits and to develop personalized prevention plans to help keep them healthy.

Annual Wellness Visit Form

Medical Record Forms & Documentation Requirements

Medical Record documentation is imperative to provide accurate and timely patient care. Clear and concise documentation ensures seamless continuity of care.

2022 HEDIS Gap Closure Tips
Medical Record Documentation Best Practices
Documenting M.E.A.T. (Monitoring, Evaluating, Assessing, Treating)
SOAP Note

Diagnosis Coding Guides and Tip Sheets

These guides will give you and your office staff additional tools for risk adjustment, coding, and documentation. These guides are intended to be used as a reference for frequently documented risk-adjustable ICD-10-CM diagnoses and ensure diagnoses are substantiated within the clinical documentation guidelines.

2023 HCC Coding and Documentation Tips with COVID-19 Updates
2023 Provider HCC Risk Adjusted Diagnoses with COVID-19 Updates
2023 Telehealth Coding and Billing Tips with COVID-19 Updates
Medicare Telehealth Services Guide(Source: Medicare CMS.org)

Note: For Medicare and Medicaid’s full list of Telehealth Services, click here

HEDIS® Coding Guide

This guide will give you and your office staff an additional tool for coding HEDIS® measures. This guide is intended to be used as a reference for the current and most frequently used codes that meet HEDIS® requirements, resulting in minimized chart retrievals due to appropriate claims/encounter data submissions.

2022 HEDIS^® Coding Guide

Desk References

These desk references provide guidelines for preventive health services, as well as condition/diagnosis documentation in the medical record.

Documentation & Coding Desk Reference
HCP HEDIS^® Desk Reference

Improving Telehealth Communications

These guides are intended to be used as reference tools when conducting TELEHEALTH visits with your patients.

Telehealth Communication Tips for Phone/Video
COVID-19 Communication: Quick Tips to Connect (ACH)
COVID-19 Telehealth: Relationship-Centered Communication Skills (ACH)

Care of Older Adults (COA)

When looking to improve the Care of Older Adults, providers should look at Advanced Care Planning, Medication Review, Functional Status Assessment, and Pain Assessment. For detailed information, use this COA TOOL.

COA Overview and Form

Patient Experience and Satisfaction

Patients with better care experiences often have better health outcomes. Use these tips to enhance your patients’ experience.

The Key to a Successful Practice – Improving the Patient Experience
Tips for Improving Patient Satisfaction – These important tips can be posted in your office to serve as helpful reminders
Quality – Health Outcomes Survey Information and Provider Tips
Education Series Webinar: Improving Patient Experience and the CAHPS® Survey

Behavioral Health Tools

Recognizing the signs of a behavioral health condition is not always easy. We are providing you with the following behavioral health screening tools to help you diagnose and refer individuals for further care. Utilizing these tools when appropriate and submitting the applicable codes will help you to satisfy HEDIS^® behavioral health measures.

EmblemHealth-HCP Your Behavioral Health Screening Tools Pocket Reference
EmblemHealth-HCP Behavioral Health Screening Tools Scoring and Action Steps

Patient Health Questionnaire (PHQ)

The purpose of the PHQ-2 is to screen for depression in a “first-step” approach. A PHQ-2 score ranges from 0-6. A score of 3 is the optimal cut-point when using the PHQ-2 to screen for depression. The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past two weeks. The PHQ-2 includes the first two items of the PHQ-9. Patients who score 3 or greater on the PHQ-2 should be further evaluated with the PHQ-9, other diagnostic instruments, or direct interview to determine whether they meet the criteria for a depressive disorder.

PHQ-2
PHQ-9

Alcohol Use Disorders Identification Test (AUDIT)

The purpose of the AUDIT is to screen and identify excessive drinking and alcohol use disorders. The AUDIT-C is a modified version of the AUDIT Tool.

AUDIT and AUDIT-C Tools

Pediatric Screenings

HCP is working closely with our health plan partners to increase the quality and efficiency of pediatric screenings for children. This guide covers best practices for child screenings within their first 1,000 days of life. Topics covered include identification, prevention, diagnosis, treatment, and follow-up care for lead screening, newborn hearing loss, and developmental screening. As part of this initiative, we are encouraging the use of CPT Code 96110 with a modifier CG or ICD-10 code Z13.41 for developmental screenings, and CPT Code 83655 for lead screenings. Early screening for these conditions is critical to the growth and healthy development of children.

EmblemHealth-HCP Pediatric Pocket Reference

Articles

Find some useful information in these articles to support compliance with HEDIS^® and CAHPS^® measures. Learn more about specific topics:

Make A Strong Flu Recommendation
Annual Wellness Visits
Colorectal Cancer Screening

Provider Resources

HCPartners in Care

Provider Communications

Become a HealthCare Partners Provider

Career Seekers

About HealthCare Partners

A New Era for HCP

Quick Links

Quality Tools

Quality Tools and Resources to Assist Your Practice

Patient Health Questionnaire (PHQ)

Quick Links

Provider Resources

HCPartners in Care

Provider Communications

Become a HealthCare Partners Provider

Career Seekers

About HealthCare Partners

A New Era for HCP

Quick Links

Quality Tools

Quality Tools and Resources to Assist Your Practice

Patient Health Questionnaire (PHQ)

Quick Links

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