The Health Services Advisory Group (HSAG) has resumed in conducting their annual Department of Health Care Services (DHCS) encounter data (claims) audit starting February 1, 2022.
- The audit study period is January 1, 2020 through December 31, 2020.
During the audit, HSAG will look for encounter data completeness and accuracy through medical record review. They will randomly select one date of service (DOS) in the study period, and providers will need to submit the medical record for that DOS. In addition, providers will be required to select a second DOS closest to the sample DOS, with the same rendering provider when possible, and submit this medical record as well.
The Alliance will begin requesting these medical records in the beginning of February. Please note that this audit will occur simultaneously to the Healthcare Effectiveness Data Information Set (HEDIS) audit. However, the sample population and audit period will be different.
- We request that all medical records be returned within 5-7 business days of the request.
If you have any questions regarding the HSAG Encounter Data Validation Audit, please contact [email protected].