AmeriHealth Caritas North Carolina Data Sharing Survey

AmeriHealth Caritas North Carolina values your partnership in delivering high quality care to your patients and our members. Data gathered in the annual Healthcare Effectiveness Data and Information Set (HEDIS) projects helps us identify opportunities for care improvement, monitor quality improvement initiatives, maintain health plan accreditation, and evaluate performance against other health plans.

Thank you for participating in our brief survey. Your feedback is important.

Question Title

* 1. Please provide the following information about your practice.

Practice Name

Practice TIN

Street Address

City

State

Zip code

Name of individual responsible for Medical Records

Title of individual responsible for Medical Records

Phone number

Fax number

Question Title

* 2. Do you use a third-party vendor for Medical Records management?

Yes

Question Title

* 3. If you answered yes to Q2, please provide primary contact information for your third-party vendor. If no, proceed to Q4.

Vendor Company name

Contact name

Contact title

Phone number

Fax number

Question Title

* 4. Do you use an EMR Vendor?

Yes

If yes, please provide the name of your current EMR vendor.

Question Title

* 5. Please let us know (by checking the box) if AmeriHealth Caritas North Carolina can follow up with your practice about the following:

Granting AmeriHealth Caritas North Carolina direct access to your EMR for medical record retrieval.

Learning more about ongoing supplemental data exchange.