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- Complete List of Quality Measures
- Provider Quality Pocket Guide
- Provider Quality Reports Frequently Asked Questions
- Overview of Report Components
- Process for Closing Care Gaps with Medical Records
- How to Filter and Sort Excel Spreadsheets (Patient-Level Detail Report)
Provider Quality Reports (PQR) are designed to help you give your patients top-notch care and also help your practice identify care gaps according to nationally accepted quality measures and standards. You'll find information about how to tailor treatment and care for your patients in two comprehensive monthly reports:
Patient-Level Detail Report
This report is in Excel format and lists your patients and shows their gaps by quality measure type and description. You will be able to view current and prospective gaps by patient and by attributed doctor. You'll also be able to see both Medicare and Commercial member care gaps on separate tabs.
Practice Summary Report
This PDF report provides performance metrics for all measures and shows how your practice is performing according to HEDIS quality measurement standards and the Medicare Star system. The results are based on Blue Cross NC claims data as well as patient health care records. This report shows the previous rolling 12 month view of care gaps.
This report includes a measure adherence chart that is color coded to allow immediate visualization of:
- Benchmark scores for the current month
- Benchmark scores for the previous month
- 5 Star Medicare cut points
- HEDIS national 90th percentile
How Do I Access My Reports?
The Provider Quality Reports are available on our secure provider portal, Blue eSM.
Simply sign into Blue e and you will be able to access the Provider Quality Reports from both the Home page and Administration tab.
Provider Quality Reports (PQR) are available to all users who currently have access to Patient Care Summary (PCS) Reports. Your Blue e Practice Administrator can assign the appropriate user role to anyone in your practice who needs to access these reports.
If you are having difficulty accessing your reports, contact the eSolutions HelpDesk at 1-888-333-8594.
We understand that incomplete claims data may result in misinformation. If you believe your information is incorrect or have concerns about your reports, you can send a request for correction. To submit corrections, follow the instructions outlined in the Process for Closing Care Gaps with Medical Records.
Questions about Reports
If you have questions about your reports, email Quality Management at Quality.Management@bcbsnc.com or call us at 1-919-765-4809.