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Availity Resources

Daily Care Gaps Available through Arkansas Health & Wellness’ Payer Space on the Availity Portal

Effective: June 1, 2019

Arkansas Health & Wellness 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, Daily Care Gaps information will be available to providers through Arkansas Health & Wellness’ Payer Space on the Availity Portal effective June 1, 2019. Care gap information is available for all Ambetter and Allwell members from Arkansas Health & Wellness.

Availity's user-friendly platform helps providers close care gaps and improve member health outcomes through the use of real-time analytics. HEDIS care gap information is updated daily by Interpreta using data from pharmacy, membership and claims. This ensures providers have the most up-to-date information to provide the best care possible for our members.

The information provided by Interpreta includes:

  • The date a member should be scheduled to see a provider when a gap has not yet been closed
  • Percentages of total care gaps that have been closed
  • Total care gaps that need to be closed
  • 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. 

Providers will continue to use Arkansas Health & Wellness’ Provider Portal to see their pay-for-performance bonus. The updated information in Availity can be used daily by providers to improve their quality performance measures.

Providers can visit Availity's website at www.availity.com to register and access website training materials.