This article is for all providers, except behavioral health providers and dentists.
Starting in February, we’ll begin to collect medical records for the Healthcare Effectiveness Data and Information Set (HEDIS) audit. Please respond to medical record requests within three weeks to ensure timely submission.
How to submit medical records
- Remote submission: We recommend partnering with us to grant direct EMR access which allows us to extract only the required information we need. This eliminates the need for your office staff to pull medical records and send them to us, saving resources for your individual practices. To set up remote EMR access, please contact Karen Sulham at 1-617-246-4409.
- Not able to submit remotely? Use secure email or fax.
- Email: HEDIS@bcbsma.com
- Fax: 1-888-641-4990
We can also set up a secure file transfer process (SFTP) for larger volumes of records.
HEDIS measurement is crucial for assessing the quality of care provided and is mandatory for NCQA-accredited health plans. As a reminder, your provider contract requires your participation in submitting records to us in a timely manner. If you use a vendor to manage your HEDIS medical record requests, it is still your responsibility to ensure records are returned to us without any additional cost.
Privacy reminder
The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule has national standards to protect patients’ personal health information. Per HIPAA requirements, please send only the minimum amount of protected health information needed to meet requests.
Questions?
If you have any questions or would like to discuss which medical record collection option is best for your practice, please call our Blue Cross HEDIS Operations Team at 1-888-994-3347.
Thank you in advance for responding promptly to this request.
MPC_112524-1N-3