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Care Gap Reports for Prestige Health Choice Members

Care Gap Reports provide:

  • Patient care information through Availity (e.g., immunizations for which the member is due).
  • Healthcare Effectiveness Data and Information Set (HEDIS®) care gap information when you need it.
  • Opportunities to improve quality of care and your pay-for-performance scores.

Find missing recommended services (care gaps) on Availity

To access this important information:

  1. Open the Payer Spaces menu on the Availity homepage and choose the Prestige Health Choice icon.
  2. Next, click Prestige Health Choice Reports on the bottom left of the page.
  3. Then, select Clinical Reports from the “Choose Category” dropdown box, and Care Gap Query from the “Choose Report” dropdown.
  4. Choose your Prestige Health Choice provider group ID on the Care Gap Query page. You can also choose specific providers within your group, specific status categories, or specific age ranges of members.

You can view a PDF or CSV version of the report. Care gap pop-up alerts will also appear on your screen (if applicable) when you check a Prestige Health Choice member's eligibility and benefits.

If you do not have access to these reports, the primary administrative assistant (PAA) within your organization can follow the instructions in the "Running a Care Gap Report in Availity (PDF)" document to update your Availity user account. Please note that, at this time, these reports are available only for patients of primary care provider offices in the Prestige Health Choice service areas.


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