Clinician Documentation & Quality Resources

Please review these required topics for HPSM providers.

Healthcare Effectiveness Data and Information Set (HEDIS)

Provide access to all medical records in a timely manner on an annual basis for the Healthcare Effectiveness Data and Information Set (HEDIS) reporting requirements.

Phone: 650-616-5016


Initial Health Assessment (IHA)

Conduct an IHA with all newly enrolled HPSM members within 120 days.

Language Assistance Services

HPSM contracted providers are required to provide linguistically appropriate services to members with limited English proficiency (LEP) or with a hearing impairment. Learn more

Phone:  650-616-2165

Facility Site (FSR) and Medical Record Review (MRR)

FSR and MRR are the application of standards by the California Department of Health Care Services (DHCS). All PCP sites must undergo an initial site review upon contracting with HPSM and subsequent reviews thereafter.

Nurse Advice Line

Understand how HPSM’s Nurse Advice Line Service supports existing phone triage systems at your clinic or office. Providers must offer members access to a phone triage service 24 hours a day, 7 days per week.

Potential Quality Issue (PQI)

Understand HPSM’s method for the identification, reporting and processing of a Potential Quality Issue to determine opportunities for improvement in the provision of care and services to our members. Direct the appropriate actions for improvement based upon outcome, risk, frequency and severity.

Seniors and Persons with Disabilities (SPD)

Identify and address barriers to access and care (physical access, communication, etc.) for seniors and/or persons with disabilities (SPD).

Tobacco Prevention and Cessation Services

Identify (initially and annually) all members (of any age) who use tobacco products and note this on the Staying Healthy Assessment (SHA).