# HEDIS chart chasing software that shows which charts are still out and who is sitting on them

> HEDIS chart chasing is the annual retrieval effort a health plan runs to pull medical records from provider offices so hybrid measures can be closed where claims alone cannot prove the service happened. The measures are not weighted evenly: under 42 CFR 422.166 outcome and intermediate outcome measures carry a weight of 3 and process measures carry a weight of 1, so a small pile of missing charts moves a Star Rating and the payment attached to it. Neurobird holds the chase list, the request, the retrieval and the abstraction result on one record.

- URL: https://neurobird.com/hedischart/
- Product: Neurobird HEDIS Chart Chasing Document Automation Platform
- Niche: HEDIS chart chasing
- Buyer: health plans and abstraction vendors
- Status: in development, open for early access
- Updated: 2026-08-22

## What Neurobird HEDIS Chart Chasing does

- Build the chase list from the measure and the gap rather than from a copied spreadsheet
- Track each request to a provider office with the method, the date and the person who made it
- Hold the retrieved chart against the measure it closes, with one authoritative copy
- Show the outstanding pile by measure weight, so the heavy measures get chased first

## How it works

1. **Build the list** Members with an open gap are grouped by provider and by measure, so one call to an office covers every chart that office is holding.
2. **Chase and record** Fax, portal, remote EMR access or an onsite visit are all logged the same way, with the date, the contact and the outcome, so a fifth call never happens by accident.
3. **Abstract and close** The abstraction result attaches to the chart and the measure together, and the pile reports itself by weight rather than by row count.

## From the source material

> HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Source: dam.assets.ohio.gov, https://dam.assets.ohio.gov/image/upload/managedcare.medicaid.ohio.gov/OhioRISE/ODM_MY_2026_OhioRISE_Self_Reported_HEDIS_Results_Submission_Specifications_F1_12.03.2025_Clean.pdf

## Industry context

- **422.166** The Medicare Advantage rule that sets measure weights: improvement measures at 5, outcome and intermediate outcome measures at 3, and process measures at 1. (source: 42 CFR 422.166, https://www.law.cornell.edu/cfr/text/42/422.166)
- **25 percent** Share of enrollees in a disaster area that can exempt a contract from HEDIS reporting, and the same rule lets other affected contracts ask NCQA to modify samples for measures that require medical record review. (source: 42 CFR 422.166, https://www.law.cornell.edu/cfr/text/42/422.166)
- **600 enrollees** Contract size at which a coordinated care or cost contract must engage an approved vendor to field the Medicare CAHPS survey alongside its other quality reporting. (source: 42 CFR 422.152, https://www.law.cornell.edu/cfr/text/42/422.152)
- **164.501** The privacy rule definition that puts quality assessment and improvement activities, including outcomes evaluation, inside health care operations rather than research. (source: 45 CFR 164.501, https://www.law.cornell.edu/cfr/text/45/164.501)
- **438.330** The Medicaid managed care rule requiring each plan to measure and report performance annually on the state's standard measures and to run performance improvement projects. (source: 42 CFR 438.330, https://www.law.cornell.edu/cfr/text/42/438.330)
- **3** The weight CMS moved the Part C Plan All Cause Readmissions measure to for the 2025 Star Ratings, one of the few notable changes from the prior year. (source: CMS 2025 Star Ratings Technical Notes, https://www.cms.gov/files/document/2025-star-ratings-technical-notes.pdf)

## Pricing

- Small plan: $399 per month
- Plan quality team: $1,100 per month
- Vendor: $2,400 per month

## Questions

### What is HEDIS chart chasing?

It is the work of retrieving medical records from provider offices during a measurement season so a plan can close hybrid quality measures that administrative claims alone cannot prove. The chase runs against a deadline, and the charts that matter most are the ones behind the heavily weighted measures.

### What are the measure weights that make a chart worth chasing?

42 CFR 422.166 sets them. Improvement measures carry a weight of 5, outcome and intermediate outcome measures carry 3, and process measures carry 1. Patient experience and access measures carried 4 through the 2025 Star Ratings and drop to 2 from the 2026 Star Ratings onward.

### Do we need a patient authorisation to request the chart?

Quality assessment and improvement activity sits inside health care operations under 45 CFR 164.501, and 45 CFR 164.506 covers disclosure for that purpose. Read those with your own counsel. What this holds is the request, the permission you relied on and the response, so the trail exists.

### Does this replace our abstraction platform?

No. It sits beside it. Abstraction stays where it is. This holds the chase itself: which office has which chart, how many times they have been asked, by whom, and what came back.

### Can a provider group use it from the other side?

Yes. The same record works as a receiving queue, showing which plan asked for what and what has already been sent, which is usually the reason an office is called a fifth time.

## Sources

- [42 CFR 422.166, calculation of Star Ratings](https://www.law.cornell.edu/cfr/text/42/422.166)
- [42 CFR 422.152, quality improvement program](https://www.law.cornell.edu/cfr/text/42/422.152)
- [45 CFR 164.501, definitions including health care operations](https://www.law.cornell.edu/cfr/text/45/164.501)
- [45 CFR 164.506, uses and disclosures for treatment, payment and operations](https://www.law.cornell.edu/cfr/text/45/164.506)
- [42 CFR 438.330, Medicaid quality assessment and performance improvement](https://www.law.cornell.edu/cfr/text/42/438.330)
- [CMS 2025 Star Ratings Technical Notes](https://www.cms.gov/files/document/2025-star-ratings-technical-notes.pdf)

## Contact

- office@neurobird.com
- https://neurobird.com/