HEDIS and Quality Initiatives
CAHPS Provider Tips
HEDIS Well-Child Documentation
NEW: HEDIS Poster
2020 Performance Poster that provides tips for MDwise providers on important preventive and clinical measures.
For more information on how to code visits, see the following posters:
Pregnancy Care
Well-Care Visits for Adults
Well-Child First
Lead Testing FAQ
Vaccine Schedule
Vaccine schedule for all children from birth to 16 years of age provided by Indiana Immunization Coalition. The provided vaccination schedules are compatible with recommendations of the Advisory Committee on Immunization Practices (ACIP), the US Center For Disease Control (CDC), The American Academy of Pediatrics (AAP) and The American Academy of Family Physicians (AAFP) and endorsed by the Indiana State Department of Health.
Access to Care Guidelines
An integral part of patient care is making sure patients have access to needed medical care. In accordance with the OMPP policy and NCQA standards, MDwise establishes standards and performance monitors to help in ensuring that MDwise members receive timely and clinically appropriate access to providers and covered services.
Indiana Health Coverage Programs (IHCP) Relationship Chart
Fax Back Program
The HEDIS fax back program allows providers to submit evidence of one or more of the following services, where a claim cannot be submitted, which include:
This information is used in calculating HEDIS-based performance rates for participating MDwise providers.
Tip Sheet
40 Weeks of Pregnancy Provider Toolkit
Learn more about the new state-wide quality initiative to address elective inductions and cesarean sections that are not medically necessary. The toolkit contains important information on recent research studies as well as provider tools and patient education.
Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey
CAHPS is an important member satisfaction survey conducted by health plans annually, in the spring of each year. The survey asks consumers and patients to report on and evaluate their experiences with their health care.
SMOKE-free Resources for Providers
The MDwise medical benefit covers smoking cessation services for HIP and Hoosier Healthwise members in the form of tobacco cessation counseling services.
Presumptive Eligibility (PE) and Notification of Pregnancy Programs
Well-Child Care/EPSDT
Best Practices for Well-Child 0–15 Months
Actively pursue missed appointments with letters and reminder calls. Reminder calls made later in the day or early evening may result in more contacts being made to the members.
AAP Periodicity and Screening Schedule
Recommendations for preventive pediatric health care from Bright Futures/American Academy of Pediatrics.
Indiana Medicaid EPSDT
HealthWatch/EPSDT provider manual
Lead Poisoning is Preventable Poster
This poster explains the importance of performing lead screenings on all children.