The Blue Cross Blue Shield Association (BCBSA) will continue to use the record retrieval vendor, Inovalon, for all retrieval of medical records on behalf of Blues plans outside of Premera’s network.
This simplifies record retrieval by having a single request come to a provider for any records being requested for any BCBSA (non-Premera) member across the country.
Inovalon will be supporting record requests for Healthcare Effectiveness Data and Information Set (HEDIS), Commercial Risk Adjustment (CRA), and Medicare Advantage Risk Adjustment (MRA) throughout the year.
For your convenience, medical records may be submitted to Inovalon in the following ways:
Inovalon is contractually bound to preserve the confidentiality of health plan members’ protected health information (PHI) obtained from medical records, in accordance with HIPAA regulations. Note that patient-authorized information releases aren’t 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 had a relationship with the patient and the information relates to the relationship [45 CFR 164.506(c)(4)]. For more information regarding privacy rule language, visit http://www.hhs.gov/ocr/privacy.
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