Mount Carmel Health Partners HEDIS Tip Sheets - Page 15

HEDIS Tip Sheet Member Outreach Tips: • Ask patients if they have had screening for colorectal cancer (see above for types of tests). • Ask patients if they have had colorectal cancer or a total colectomy if not noted in the chart. If patients have had colorectal cancer or a total colectomy, please note for future reference. • A colorectal cancer screening should be covered under a patient’s insurance benefits. For questions regarding coverage, the patient should contact his or her insurance company. • Patients may need a referral from their PCP for screening. Supplemental Data Tips     Any colonoscopy within the past 10 years counts for meeting the measure, even if the patient has had a FOBT or flexible sigmoidoscopy since then. Documentation in the medical record must include a note indicating the date when the colorectal cancer screening was performed, may use pathology report as long as it indicates the date and type of screening. A result is not required if the documentation is clearly part of the “Medical History” section of the record; if this is not clear, the result or finding must also be present (this ensures that the screening was performed and not merely ordered). It is always best to have the results. Member-reported data is not allowed. For example, the patient states, “I had a colonoscopy in June,” is not valid. 15