Its role is to assure that goods and services are procured efficiently, effectively, and economically promote competition in contracting provide safeguards for maintaining a procurement system of quality and integrity and assure that HABC purchasing actions are in full compliance with applicable Federal, State, local laws and regulations.
#VENDOR OVERSIGHT PROCESS PROFESSIONAL#
The department also procures a myriad of professional services, including pest control, legal, architectural and engineering services. A wide variety of goods and professional services such as office supplies, stoves and refrigerators, various construction items, etc. The HABC Procurement Department handles all procurement and contracting activities for HABC. Plans, Reports & Policies Plans, Reports & Policies.Fair Housing Reasonable Accommodations Policy.Engineering, Energy, and Construction Division.Housing Quality Standards Inspections Checklist.Rental Assistance Demonstration Program.Always perform a reasonability check of final calculated rates.Validate a small sample of vendor data (medical record review, HEDIS numerators and denominators).Formally document all oversight activities.Spell out expectations clearly in vendor contracts.The MCO is ultimately responsible for all vendor activities.Assess whether the vendors have accurate medical record data collection tools and a sample of completed data collection tools.Īudit Standards and Examples of Appropriate Monitoring of Calculation Vendors Vendor rules of thumb:.Confirm that the vendors follow HEDIS administrative data specifications.Vendor administrative databases, policies and procedures Īudit Standards and Examples of Appropriate Monitoring Auditors will:.Vendor data collection tools and instructions.Vendor Oversight Vendors who collect and calculate performance measures: Any vendor delegated to collect, calculate, and/or report HEDIS data must comply with all relevant standards.Īudit Standards and Examples of Appropriate Monitoring of Calculation Vendors MCOs must ensure that all vendor work products meet audit standards, including: Review and validation of a sample of provider credentialing files.Certification reports for credentialing.Review of policies and procedures on provider data processing.Evidence of appropriate turn-around time for processing of eligibility/enrollment data.Īudit Standards and Examples of Appropriate Monitoring of Data Processing Vendors Practitioner Data – Data Capture, Transfer and Entry.Review of policies and procedures on enrollment file processing.Īudit Standards and Examples of Appropriate Monitoring of Data Processing Vendors Enrollment Data –Data Capture, Transfer and Entry Review of policies and procedures on claims processing.Monitoring vendor data error reports and subsequent resolutions.Periodically review and measure vendor performance against quality and timeliness standards.Īudit Standards and Examples of Appropriate Monitoring of Data Processing Vendors Medical Services Data – Sound Coding Methods and Data Capture, Transfer and Entry.Require data submission from vendors on a timeline consistent with HEDIS reporting time frames.Communicate and enforce data quality standards (typically these are addressed in the vendor contract).
Identify what plans should strive towards in order to accurately report HEDIS measures.Used to assess the organization’s ability to report HEDIS data accurately and reliably.Describe requirements for HEDIS® data collection and reporting processes.HEDIS Audit – Appropriate Monitoring and Oversight of Vendors Presenter: Yolanda Strozier, MBAProject Manager, EQRO Services
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