Reminder: 2023 Deadlines for Blue Medicare Advantage Care Gap Closure

With the holiday season ramping up, here’s your reminder that it’s also HEDIS^® season for Blue Medicare Advantage! To assist with gap closure and earning the quality performance incentives you deserve, keep these important dates in mind:

• December 15, 2023 – Medical records for gap closure should be submitted
• December 31, 2023 – Last day to provide services for 2023 measures
• February 28, 2024 – Claims with CPT^®, CPT^®II, or diagnosis codes supporting 2023 HEDIS^® service(s) must be processed to count for gap closure. Please remember to allow up to 30 days for claims processing when submitting. 
• June 2024 – 2024 Stars Incentive Program Payout

Next Steps

1. Review your most recent MA Member-Level Detail Report
2. If the report indicates a quality measure is OPEN and the service(s) has been rendered, ensure a claim or, if applicable, portion of the medical record that documents the service/test(s)
3. If the report indicates a quality measure is OPEN and the service(s) has not been rendered, ensure the patient is scheduled for the service by December 31, 2023

Gap Closure through supplemental documentation submission (applies to COL, CBP, and EED HEDIS^® measures):

• Submit the portion of the medical record that documents the service/test, along with the patient’s results and demographic information 
• Submit by December 15, 2023, one of the following ways:
  • Fax: 833-505-2348, Attn: HEDIS Ops
  • Email: [email protected] 

  • Mail: 

    Blue Cross and Blue Shield of Kansas
    PO Box 260
    Southfield, MI 48037-0260
    Attn: HEDIS Ops, TC1402-E

Gap Closure through Claim Submission:

• Submit a claim capturing the CPT^® category I or II code supporting the HEDIS^® measure once the service is rendered
  • CPT^® II codes submitted on MA claims to report HEDIS^® compliance should reflect a $0.01 charge
• For additional information, please review the document “Understanding Star Ratings 2023 Reference Guide”.

If you have any questions regarding this publication, please reach out to your BCBSKS MA provider representative. 

As always, thank you for your partnership providing quality care to our fellow Kansans!

Healthcare Effectiveness Data and Information Set. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). 
CPT Copyright 1995–2023 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.