February 6, 2020
Each year from February through May, Premera requests medical records to comply with requirements for Healthcare
Effectiveness Data and Information Set (HEDIS®) and Centers for Medicare & Medicaid Services (CMS) star quality standards for patient care.
We will be working with Ciox to retrieve medical records for your Premera Medicare Advantage patients. Ciox will also retrieve medical records for patients who live in Washington state
but are enrolled in another state’s Blue Cross Medicare Advantage PPO plan.
The Ciox team will be contacting you to retrieve medical records. They will provide the list of records required, documentation requirements, and options for you to submit records
through a secure online portal, fax, or mail.
You are permitted to comply with medical record requests without patient-authorized information releases when both the provider and healthcare 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.
If you have chosen to give Premera access to electronic health record system (EHR) for record retrieval, your office won’t be contacted by Ciox.
If you have questions about these upcoming medical records requests, email ProviderClinicalConsulting@premera.com.