Press release

CitiusTech’s Quality Management Platform BI-Clinical Receives NCQA Certification for All HEDIS® 2020 Measures

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CitiusTech, a leading provider of healthcare technology services and solutions, has received the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS®) certification for BI-Clinical, its healthcare quality management and analytics platform.

BI-Clinical has been certified by NCQA for its 2020 HEDIS® coverage performance measures, including administrative and hybrid measures, allowable adjustment and Electronic Clinical Data System (ECDS) rules and systematic sampling. BI-Clinical is one of the most widely used quality and analytics platforms in North America, with deployments at over 5,000 payer and provider locations and supporting more than 70 million lives. BI-Clinical covers one of the largest varieties of regulatory (Medicaid, HEDIS®, HCC, STAR), contractual, operational and financial initiatives. It is powered by the industry’s fastest rules engine that runs at the speed of business to meet and exceed payer and provider needs.

HEDIS® is one of healthcare’s most widely used performance improvement tools with over 191 million people enrolled in plans that report HEDIS® results. BI-Clinical has met the milestone of HEDIS® certification for the seventh consecutive year and is one of the first solutions in the market to be certified this year. This helps customers meet their compliance goals and stay up to date with regulatory requirements.

BI-Clinical also powers CitiusTech’s SCORE+, an end-to-end HEDIS® performance management suite that helps healthcare organizations accelerate quality reporting and enhance collaboration for gap closure. SCORE+ is powered by a robust workflow engine that drives multiple workflow requirements for health plans including medical records and year-round HEDIS® review.

“BI-Clinical is the only solution in the industry that is certified for both payer and provider-centric performance indicators, giving payers the flexibility to drive provider rules as advocated by 2020 NCQA adjustment rules,” says Shyam Manoj, vice president of health plans at CitiusTech. “BI-Clinical and SCORE+ integrate seamlessly to provide a holistic solution that improves quality management and delivers superior performance for payers.”

SCORE+ is a scalable, modular solution that helps health plans accelerate their journey to quality improvement. It offers self-service capabilities that facilitates accurate decision making ​while empowering organizations to understand how and where to improve. SCORE+ also assists with prospecting as well as other quality programs (STAR, VBP, etc.). It is fast, comprehensive, efficient and aligns perfectly with an organization’s HEDIS® strategy enabling increased revenues.

“HEDIS® analytics and quality reporting is tricky,” says Jeffrey Springer, senior vice president of healthcare solutions at CitiusTech, “and catering to programs beyond regulatory initiatives is even trickier. Organizations need to sift through a tremendous amount of data to identify gaps and close them. SCORE+ is an end-to-end performance management solution that includes state-of-the-art capabilities to drive quality strategy using as-is regulatory measures or award winning capabilities to customize quality strategies that can drive campaigns, abstract charts and engage providers to accelerate Value-based care, HEDIS®, risk and population health.”

About CitiusTech

CitiusTech ( is a specialist provider of healthcare technology services and solutions to medical technology companies, providers, payers and life sciences organizations, with over 4,000 professionals worldwide. CitiusTech’s services and solutions include management consulting, healthcare software development, healthcare interoperability, regulatory compliance, BI/analytics, consumer engagement, care coordination and population health management. CitiusTech helps customers accelerate innovation in healthcare through solutions and accelerators for clinical quality reporting, healthcare big data, cloud computing, mobile health and predictive analytics. With cutting-edge technology expertise, world-class service quality and a global resource base, CitiusTech consistently delivers best-in-class solutions and an unmatched cost advantage to healthcare clients worldwide.

About National Committee for Quality Assurance (NCQA)

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS) is a set of standardized performance measures designed to make sure purchasers and consumers have the information they need to reliably compare the performance of managed health care organizations. NCQA’s Web site ( contains information to help consumers, employers and others make more informed health care choices.