February 21, 2019
We’re working with CIOX Health this year to retrieve medical record for our Premera Blue Cross Medicare Advantage plans. CIOX Health will retrieve medical records on our behalf.
We request medical records to comply with:
- Healthcare Effectiveness Data and Information Set (HEDIS®) requirements, and
- Centers for Medicare and Medicaid Services (CMS) risk adjustment standards for data submission and star quality standards for patient care
You won’t need to submit patient-authorized information releases to comply with medical record requests when both the provider and health care plan have a relationship with the patient, and the information relates to this relationship [45 CFR 164.506(c)(4)]. For more information about privacy rules, go to hhs.gov/ocr/privacy.