Quality Improvement Resources
Welcome to our Quality Improvement Resources! At Aetna Better Health of Pennsylvania, we value our provider partners. We want to make it easy for you to care for our members and guide them down the path to better health.
To achieve this goal we have developed the Quality Improvement Resources. This resource will benefit you in the following ways:
- Help improve HEDIS Ratings, Pay for Quality Scores, and incentive payments
- Provide coding tips from the National Committee for Quality Assurance (NCQA)
- Allow easy access to important provider documents and tools.
Quality Measure Educational Documents
Quality Measure Educational Documents include both HEDIS measures developed by the NCQA and Performance Measures for the State of Pennsylvania
New for 2020- ECDS Quality Measures
Collecting Measure Data Using ECDS
Adult Immunization Status (AIS)
Breast Cancer Screening (BCS-E)
Depression, Remission, or Response for Adolescents and Adults (DRR-E)
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E)
Follow-Up Care for Children Prescribed ADHD Medication (ADD-E)
Postpartum Depression Screening and Follow-Up (PDS-E)
Prenatal Depression Screening and Follow-Up (PND-E)
Prenatal Immunization Status (PRS)
Unhealthy Alcohol Use Screening and Follow-Up (ASF)
Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS-E)
Practitioner Information Change Form
When you need to update information for you practice, i.e. adding a new PCP to your roster, this form needs filled out and sent in to the plan.
Provider Secure Web Portal Registration Form
Register for this portal to access claims information, member panels, additional forms, the Provider Report Management Tool, and much more!
Member Care Information Portal Registration Form
Register for this portal to electronically upload Obstetrical Needs Assessment Forms (ONAFs). Incentives are tied to electronic uploads in the P4Q Program.
Provide this form to members that may be attending screening events where codes are not submitted. This signed form can be added to the patient's record and count towards your HEDIS scores!
Aetna Better Health of Pennsylvania and Aetna Better Health Kids encourage our provider network to continue to provide family planning options to your patients, incorporate long-acting reversible contraceptives (LARC) counseling, and support access to LARC in all clinically appropriate circumstances.
Long-Acting Reversible Contraception (LARC)
This guide walks you through utilization of the secure web portal
Member Care Information Portal Guide
Learn how to upload ONAFs electronically to the Member Care Information Portal
Provider Report Management Tool Overview and Navigation
Learn how to access this tool where you can pull Quality Reports such as HEDIS Gaps in Care
Medicaid Pay-for-Quality (P4Q) Tip Sheet
You may be eligible to earn more compensation with our Pay for Quality (P4Q) program! Refer to this tip sheet for information on the program, eligibility, and incentives
Understanding Social Determinants of Health ICD-10 Codes
Community Health Workers Maternity Program Overview
HEDIS Improvement Webinars/Videos
View past webinars to learn how you can improve HEDIS rates and member health outcomes.
For a complete listing of all offerings in 2021 click here.
Billing and Coding Guides