HEDIS Compliance Audit: Certification Overview and Exam

To become a Certified HEDIS® Compliance Auditor, you must pass the HEDIS Compliance Audit™ exam. The exam is typically offered twice a year.

The next exam review and session is December 10–11, 2018, at NCQA Headquarters in Washington, DC.

Day 1: Certification Overview. Participants should already know the HEDIS Compliance Audit process. Day 1 is a half-day overview of the HEDIS Compliance Audit program and methodologies, and covers:

  • An overview of the program.
  • The examination structure and strategies.
  • Audit preparation.
  • Audit methodologies for information systems and HEDIS determination.
  • Audit reporting.
  • Ethical standards.

Day 2: HEDIS Compliance Audit Exam. The exam begins in the morning; participants have 4 hours to complete it. There are both conceptual and applied questions.

Fees

The combined fee for the application, certification review session, examination, HEDIS manuals and certification is $6,000. Participants are allowed 2 opportunities to participate in the review and examination before the fee is forfeited.

Certification

Participants who pass the certification examination receive the designation of Certified HEDIS Compliance Auditor. Certification is valid for 1 year, upon agreement with all contractual requirements for maintaining certification. Certified auditors renew certification annually, following NCQA approval and a recertification fee of $2,100.

Questions?

Submit them through My NCQA. Select “HEDIS Audit” as the program type.

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