HEDIS® Web Portal

HEDIS® Web Portal-User Interface

The following are Screen Shots and a Description of the HEDIS® Web Portal User Interface

Log in Workspace:

Log into the Web Portal by entering the following:

Enter: User Name Enter: Password Select: Log In

Provider Directory: Takes you to the Premier online database of credentialed providers

Contact: Provides phone number for the HEDIS Department and the Premier Eye Care mailing address

Instructions: Provides link to the HEDIS Web Portal instructions and a video on the how to use the Retinal Camera

HMO Workspace

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Item Explanation

Filter By Health Plan Filter search results by specified Health PlanSearch By ID or Name Search by specified PCP/Group ID# or NameRows Per Page Customizes the # of records displayed per pageShow Members for All Displays all Members for all PCPsPCP/Center ID Displays either the Center ID# or PCP ID# associated with this Group

or PCP Office. Hyperlink takes the business user to the Center/PCP DRE eligible Member list

Name The name of the Group or PCP OfficePlan Name The Health Plan nameLOB (Line of Business) Medicare or MedicaidEligible Member Count Total DRE eligible MembersPremier Compliant Count Total Premier compliant DRE eligible Member countPremier Star Rating Premier Star Rating based on compliant Member countStar Progress How many more DREs needed to reach the next star levelHealth Plan Compliant Count Total Health Plan compliant DRE eligible Member countHealth Plan Star Rating Health Plan’s Star Rating based on compliant DRE eligible Member

count

Provider Directory Links access to the Premier Provider DirectoryContact Lists Premier Eye Care’s HEDIS® department address and phone

number

Log Out Log out of the HEDIS® PortalInstructions Link to a video of how to operate the Retinal Camera and a link to

the documented HEDIS® Portal instructions

Member Listing Workspace

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Item ExplanationShow All Outreach History

Click on this to show all outreach for all Members

> Click on this item to move to the next pageClick on this item to move to the last page

Click on this item to export a sortable list of all DRE eligible Members to excel

Find/Next Search by specified Member ID# or NameBack to PCP/Group List Takes the business user back to the first page with the PCP/Group listMember ID Member ID #. Hyperlink takes user to the Member Details workspaceMember Name Member Last Name followed by First NameD.O.B. Member Date of BirthPhone Member Phone NumberLanguage Member preferred LanguagePremier Compliant? Member compliancy associated with PremierPlan Compliant? Member compliancy associated with the Health PlanLast Outreach Last Outreach Action to the Member by PremierSubmission Status Shows date and status of the submission of the Retinal Images

o Pending: Submission started by user but not yet submitted for interpretation

o Submitted: Images submitted by user but not yet interpreted

o Rejected: Rejected by Interpreter due to poor image quality

o Processed: Sent back by interpreter with DRE screening form and diagnosis

Zip Member’s Zip CodeD.O.B. Member’s date of birthPCP ID & PCP Name (Scroll left)

ID # and Name for the PCP

Note Selecting the header of any column will sort the contents for that columnShow All Outreach History

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Shows all the outreach history for each Member

Member Details Workspace

Click on a Member ID to see the Member Details workspace, which allows you to see additional Member data, outreach history and retinal image submission

Member Details: Provides information of the Member’s Details: Member ID#, Name, DOB, Plan Type, Phone #, Language, Zip, PCP ID#, Member DR Compliant?, PCP Name.

DR Exam Service Details: Provides information about the Member’s Current year and Prior Year DRE Exams if available.

Item Explanation

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Premier Claim Number The Claim Number if there is a claim on file DOS The Date of Service of the DRERend. Prov. The Name of the Provider seen by the MemberOffice Name The Name of the Provider’s OfficeService Code The CPT CodePrimary Diagnosis The Diagnosis CodeDR Positive States if the Member is positive for diabetic retinopathy or not

Outreach History: Provides history of all current year outreach to the Member by the Premier Eye Care HEDIS® team.

Item ExplanationOutreach Date/Time The date and time that the particular outreach was doneOutreach Action/Result Describes the outcome of the outreach to the MemberNotes from Outreach Team Additional information about the result of the outreach when availableNext Page Click this to go to additional pages of Outreach Actions and Notes if

available

Submissions for this Member: Provides the history of retinal submissions for the Member

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Item ExplanationOpen Click this to open the submissionID ID Number assigned to the submission Submission Type Description of the submission, e.g., DRE Retinal ImagingStatus Status of the Submission – Pending, Submitted, Processed or RejectedSubmission Notes Any notes that were included by the SubmitterReview Notes Notes made by the InterpreterCreated On The date that the submission was created/processedCreated By The Username of the entity that made the submission

Retinal Image Submission

To add a retinal image, select “Create New Submission” to bring up the Submission Detail Screen

Submission Details Screen

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Item ExplanationMember Name & ID States the Member’s Name and ID NumberDiabetes Info D.M. Type: Choose either Diab. Mellitus 1 or Diab. Mellitus 2. If the

type is not known it will default to [Unknown].Status: Choose either Controlled or Uncontrolled. If the status is not known it will default to [Unknown].

Last A1C Test A1C Value: Enter the A1C Value if knownDate Tested: Enter the test date in mm/dd/yyyy format

Comments Enter any comments about the Member if necessarySave Changes Click to save the comments

Attach New Document

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Select “Attach New Document” to go to the Attached Document Details Screen

From the Drop Down List “What type of document(s) are you attaching”, select if you are attaching the Left or Right eye image

Select Choose Files to find the saved image from your desktop or other location Navigate to the location of the image and select Open to attach

Note: Whether you use the loaner camera or your own camera, browse for images on your desktop in the folder where images have been saved

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Select Attach Document to attach image.

Example of attached document:

Once the document is attached you can do the following:

Attach Document : Attach additional documents as many times as needed before submitting for review

Delete : Delete photo/document you do not want to submit for review

Submit for Review : When done attaching documents, submit for review from doctor

Notes: Changes cannot be made to document once “Submit for Review” is selected and new submissions cannot be entered

Cancel Submission : Cancel all information added and start over again

Back to Member Detail : Takes you back to Member Details and allows you to come back to this screen

Download : Click to view attached document

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Health Plan

Once Submit for Review is selected, all fields are grayed out except for: “Back to Member Details” & “Download”.

Retinal submissions can be retrieved two ways:

1. Selecting the PCP ID and choosing the following options:

Submission Summary: Select this option to see the full list of submissions for PCP ID Select Member ID

Select Open on the Submission

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2. Selecting the following on the first page of the HEDIS Portal:

Select the Show Members for All button in the first page

Search by Member Name/ID

Open the submission

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The Member details workspace with processed images includes the Interpreter notes, Diagnosis, Follow-Up recommendation and an exportable DRE Screening form.

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