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Availity Portal: Daily Care Gaps from the Interpreta Clinical Action Tool

Date: 05/03/21

Arizona Complete Health understands that a more coordinated, comprehensive approach to care improves quality and health outcomes for our members. To better collaborate and support provider efforts to care for our members, we’re excited to announce a new feature available to you through our Payer Space on the Availity Portal: Daily Care Gaps from the Interpreta Clinical Action Tool.

Interpreta’s Clinical Action tool provides real-time data and analytics to help you close care gaps and improve member health outcomes. Interpreta updates HEDIS care gap information is on a daily basis using data from pharmacy, membership, claims and supplemental sources. This ensures you have the most up-to-date information to provide the best care possible for your patients. It also provides a complete snapshot of a provider's performance, including the percentages of total closed care gaps, total care gaps that need to be closed and total care gaps that are past deadline for closure.

Interpreta defines the status of care gaps as follows:

  • Compliant: When a member's status with a quality measure has adhered to guidelines for care for the measurement year.
  • Due: When a member has a future clinical due date in the measurement year for which an action needs to be taken to place the member into compliance before the deadline date.
  • Overdue: When a member has a past due clinical date in the measurement year for which an action is required to place the member into compliance.
  • Past Due: When no appropriate action was taken to bring a member into compliance and it is no longer possible to bring a member into compliance for the measurement year.

We are excited to bring this tool directly to you. Directions for creating an Availity account are attached to this email. Registration is easy - all you need is your Tax Identification Number (TIN) and an email address. Training materials on accessing the Availity Portal, the Arizona Complete Health Payer Space, and accessing Daily Care Gaps will be provided soon.