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Appendix 2 HEDIS Roadmap APPENDIX 2 HEDIS ROADMAP Introduction Welcome to the NCQA HEDIS Compliance Audit? tool, the HEDIS Record of Administration, Data Management and Processes (Roadmap). The HEDIS Roadmap collects information about how your organization’s information management practices affect HEDIS reporting; it is not meant to evaluate the effectiveness of your organization’s information systems. Changes to the HEDIS Roadmap In 2008, NCQA convened a panel of auditors to assess the design and usefulness of the existing information-collecting tool—the BAT. The result of their discussions and review is this redesigned document—the Roadmap. We believe this tool better fits the needs of the variety of organization participants and that it more clearly defines the systems and processes auditors need to understand when they perform an audit. Because the tool has changed so radically, this introduction does not list all the differences between the “old” BAT and the “new” BAT, but there are general changes. Specific sections and tables are provided for appropriate vendors The distinction between baseline and yearly questions is removed Renumbered sections align chapters with standards Completing the HEDIS Roadmap Completing the Roadmap is a required component of the NCQA HEDIS Compliance Audit process. The Roadmap’s tables provide auditors with the preliminary information they need to conduct the audit. All information requested in the Roadmap is essential to the audit process, and auditors require the organization to answer each question accurately and completely. An electronic copy of the Roadmap is available on the NCQA Web page and provides additional guidance for plans using HEDIS certified software. Keep the following in mind. A separate Roadmap must be completed for each organization that participates in the HEDIS audit process The organization must complete a new Roadmap, or update a previous one, every year The auditor may not prepare the Roadm