Responding to requests for medical records

December 10, 2019

As outlined in your Provider Agreement with Independence, you are required to respond to requests in support of Healthcare Effectiveness Data and Information Set (HEDIS®), risk adjustment, and government-required programs related to the Affordable Care Act within the requested time frame. Inovalon, an independent company, facilitates these requests on our behalf. They retrieve medical records for out-of-area Blue members on behalf of the Blue Cross and Blue Shield Association (BCBSA), an association of independent Blue Cross® and Blue Shield® plans.

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. 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.

Learn more

For more information regarding the HIPAA privacy rule, please visit the U.S. Department of Health & Human Services website.

For more information about the BlueCard® Program, visit the BlueCard section or email provider_communications@ibx.com.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Used with permission.

Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.