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Upcoming HEDIS® Medical Record Review for Out-of-Area Members

Audience: Providers and Health Care Practitioners

We are providing advance notice of an upcoming medical record retrieval initiative in support of the Healthcare Effectiveness Data and Information Set (HEDIS®).

To assist with this effort, the Blue Cross Blue Shield Association has engaged an independent company, Inovalon, Inc. (Inovalon), to collect medical records on behalf of participating Blue Cross Blue Shield plans for members who receive services outside of their plan’s service area.

Inovalon’s medical record collection efforts will take place from February 10 – May 1, 2020. Please keep this information on hand so that you are prepared if Inovalon contacts you regarding its record retrieval efforts.

An Inovalon representative will work with your office to obtain copies of records in a manner that is the most convenient for you.

Please note that Inovalon is bound by the terms and conditions of a business associate agreement executed with the Blue Cross Blue Shield Association. Additionally, each respective Blue Plan has an executed business associate agreement with the Blue Cross Blue Shield Association. Appropriate safeguards are in place to ensure full compliance with all defined privacy and security provisions. Your participation agreement with Excellus BlueCross BlueShield supports the request for medical records.

One of the ways we measure the success of our shared continuity of care and overall quality goals is through analysis of the data we collect annually in our HEDIS® review. Thank you for your cooperation and collaboration with this important work.

 
 
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