Healthfirst encourages your practice to actively identify patients younger than two who need vaccinations and to help their parents and/or guardians resolve barriers with scheduling well-child appointments. These visits provide an opportunity for parents and guardians to:

• Track their child’s growth and development
• Discuss concerns about their child’s health
• Make sure their child gets all their recommended vaccinations by age two

2025 Healthfirst Quality Incentive Program (HQIP)

Best practices and tips

• Vaccinations may be rendered at doctor appointments, including sick visits, regardless of the primary intent of the visit.
• Use all touchpoints with parent to check/schedule well visits.
• Use a manual or automatic reminder and recall strategy. See the American Academy of Pediatrics Reminder and Recall Strategies
• When treating a child who needs a well-child visit, you can convert their sick visit to a well-child visit by using the appropriate procedure code.
• For multi-dose vaccination, schedule the child’s next vaccine/dose as soon as the minimum interval will allow.
• Submit claims or supplemental encounter data to Healthfirst for well-child visits.

Member wellness rewards

Please advise patients’ parents and/or guardians that they may be eligible to receive Wellness Rewards for completing well-child visits and vaccinations.

Provider resources

• Healthfirst Provider Guidebook for Quality Measures
• HEDIS® Codebook
• Optimizing Telehealth to Achieve HEDIS Measures
• Clinical Support Vendors and Behavioral Health Resources
• For pediatric providers and office staff/coders who want to learn more about proper billing and coding, view our Jan 2025 recorded webinar: Care to Coding: Guiding Pediatric Care Providers to Successful Coding for Billing, Risk and Quality

Healthfirst Member Services is here to help

Patients can contact their plan’s Member Services team for help scheduling or getting to their appointments, or for more information about Wellness Rewards. Member Services contact information can also be found on the back of the member’s ID card; see sample ID cards here.

For more information about recommended health screenings for your patients, please contact your assigned Clinical Quality Manager or Network Account Manager. You can also call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am–5:30pm.