Has anyone had any negative experiences while on the road doing HEDIS?

[mmad09]

Hi All,

I just registered here on allnurses and work in quality improvement at a MCO. For the most part, my HEDIS experiences have been positive; however, every now and then I have come across staff at doctors' offices who have been rude and hostile. Anything to make our job more difficult. Just inquiring if anyone else here have had bad experiences or horror stories you'd like to share. Our HEDIS season will soon be coming to a close. I think, by the time we are done, I'll have reviewed over 1000 charts and visited about 180 offices since early March.

Looking forward to hearing from you QI nurses who do HEDIS or any other chart review project.

mmad09

[RubyRN,CHPN]

I remember a couple years ago I was doing a large volume of PIA audits for a medicare advantage program at a rural health clinic. Apparently, they had given me a desk in the clinic manager's office which was also shared by the bookkeeper and the lead nurse. I worked very quietly and quckly processing at least 8-10 charts an hour. From the get go, the office manager, who's leadership style was mother authoritarian, informed me that she felt auditors who visited her office were relatively inept. For three days she carried on in the most unprofessional manner, gossiping about the clinic staff, belittling the nursing support staff, yelling at pt's on the phone for missing appintments, and referencing that she was not going drop the contract for the medicare advantage plan that I was representing mainly because of the large volume of charts that were assigned at the site. Then there was this cackling laugh after everthing she said, so shrill. It was 3 days of pure unprofessional hell. I reported her to my field advocate particularly what she said about cancelling the contract. Field advocate called her everyday to see how things were going with the audit in my presence . Judging by the tone of her voice she had nothing negative to say in front of me. She got real quiet when she was questioned by the field advocate, obviously got called out on it. LOL....