As previously announced, effective January 1, 2018,
Inovalon, an independent company, was selected by the Blue
Cross® Blue Shield Association® to retrieve
medical records for out-of-area Blue members. Inovalon will coordinate
medical record requests from Blue Cross® and Blue
Shield® companies across the country and help reduce multiple
requests for patient data. This arrangement supports Healthcare Effectiveness
Data and Information Set (HEDIS®), risk adjustment, and
government-required programs related to the Affordable Care Act.
Requests for medical records
As outlined in your provider agreement with Independence, you are required
to respond to requests in support of risk adjustment, HEDIS, and other
government-required activities within the requested time frame. This includes
requests from Inovalon on our behalf. Independence is working diligently to
make this process as simple as possible.
For your convenience, medical records may be submitted to Inovalon using any
of the following methods:
- Fax. Fax medical records to 1-877-221-0604.
- FedEx®. For further instruction on
returning medical records via FedEx, please call
1-800-463-3339.
- Email. Send medical records via secure email to EMRService@inovalon.com.
If you have questions on delivery options and methods, call Inovalon at
1-844-682-9764.
HIPAA and privacy
Inovalon is contractually bound to preserve the confidentiality of health
plan members’ protected health information (PHI) obtained from medical
records, in accordance with the Health Insurance Portability and Accountability
Act (HIPAA) regulations. Please note that patient-authorization is not required
for you to comply with these requests for medical records.
Providers are permitted to disclose PHI to health plans without
authorization from the patient when both the provider and health plan have a
relationship with the patient and the information relates to the
relationship.
For more information regarding the HIPAA privacy rule, please visit the U.S.
Department of Health & Human Services website.
Independence Blue Cross is an independent licensee of the
Blue Cross and Blue Shield Association.
HEDIS is a registered trademark of the National Committee
for Quality Assurance (NCQA). Used with permission.