New medical record retrieval coordinator for ACA programs

June 21, 2018

Independence is pleased to announce that effective January 1, 2018, Inovalon, an independent company, was selected 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 (ACA).

Requests for medical records

As outlined in your contract, 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 Health Insurance Portability and Accountability Act (HIPAA) regulations. Please note that patient-authorized information releases are 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 privacy rule language, 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.