Audit Timeline

Below is a typical timeline based on a June submission of HEDIS results to NCQA or a state agency.

• Contract with client finalized by November

• Baseline Assessment Tool is sent to health plan by mid-November

• Onsite visit dates confirmed and tentative agenda outlined in December

• BAT is completed and returned 6 to 8 weeks prior to the site visit

• Conference call is placed to confirm site visit and discuss outstanding issues 3 weeks prior to site visit

• Onsite audit visit scheduled for the February-April period

• Follow-up report sent 10 working days after the site visit

• All actions required from onsite audit completed by May 15 or June 1, based on reporting requirements and line of business

• Interactive Data Submission System (IDSS) made available to the auditor for verification of calculations no later than June 1 or June 15, based on reporting requirements and line of business

• Auditors verify measure rates, issue final measure determinations, lock the IDSS, and approve the submission of HEDIS results to NCQA and/or state agency by June 15 or June 30, based on reporting requirements and line of business

• Final Audit Report issued to health plan and NCQA within 30 days after Final Audit Statement is rendered and IDSS submitted to NCQA and/or state agencies