CIOX to retrieve medical records for risk adjustment services

Blue Cross Blue Shield of Michigan and Blue Care Network will use CIOX Health to perform medical record retrieval for risk adjustment services for our commercial (non-Medicare) members beginning in October 2018.

Blue Cross and BCN request medical records every year to meet the Centers for Medicare & Medicaid Services’ standards for data submission and coding accuracy and CMS’ and Health and Human Services’ regulations and quality standards for patient care.

CIOX is contractually bound to preserve the confidentiality of members’ protected health information obtained from medical records, in accordance with the Health Insurance Portability and Accountability Act of 1996.

You won’t need to submit patient-authorized information releases to comply with medical records requests when both the provider and health care plan have a relationship with the patient, and the information relates to this relationship [45 CFR 164.506(c)(4)]. For more information about privacy rules, go to the U.S. Department of Health and Human Services website*.

If you have any questions, contact your provider outreach consultants.

*Blue Cross does not control the content of this website.