Medicare Part C and Part D Data Validation

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Our senior team members developed
the original NCQA HEDIS
Software Certification ProgramSM.

Successful Completion of Similar Projects

Healthy People has successfully completed similar data validation projects.  Last year, our firm conducted numerous Part C/Part D Data Validations.  Healthy People is licensed by the National Committee for Quality Assurance (NCQA) to perform HEDIS® Compliance Audits. All of our audits have been completed within budget and on-time.

100% of our 2023 clients would recommend us to their peers.
100% of our 2023 clients said they had a good experience with our firm.

Facility Requirement Compliance

Healthy People operates in an environment that is fully compliant with HIPAA privacy and data security requirements. Healthy People’s facility and equipment comply with applicable industry security standards. Healthy People maintains appropriate administrative, technical, procedural, and physical procedures to safeguard the data validation information. Healthy People uses a secure client portal for the exchange of data between the organization and the data validation team.

Company Expertise

The Healthy People Team possesses the following expertise:

  • Knowledge of the Part C and Part D Reporting Requirements and Technical Specifications.
  • Knowledge of managed care and pharmacy benefits operations and management and how they relate to Medicare Part C and Part D.
  • Demonstrated understanding and subject matter expertise of Title I and II of the Medicare Modernization Act (MMA), Medicare Part C and Part D regulations (42 CFR § 422 and § 423), Medicare Managed Care Manual and Prescription Drug Benefit Manual.
  • Ability to evaluate an organization’s performance of Medicare Part C and Part D data collection, storage, compilation, and reporting using CMS’ data validation standards.
  • Ability to conduct source/programming code review.
  • Ability to interface with a variety of data systems in a secure environment.
  • Experience in conducting data validation for commercial entities, including NCQA HEDIS Compliance Audits.
  • Previous experience conducting similar types of data review and validation with projects of similar size and scope.
  • Thorough understanding of HIPAA and Privacy requirements.

We invite you to attend a free educational webinar presentation about Part C/Part D data validation auditing or to request a proposal to learn more about how we can expertly help your organization with your Data Validation Review.

The core principles of our audit review philosophy are outlined below:

1. We conduct a streamlined and efficient review.
2. We are flexible and collaborative.
3. We cause the least disruption possible.
4. We help ensure your audit success.
5. We provide excellent customer support.

Our Data Validation Reviews are high quality and low cost.