Medical Record Retrieval Program

Medical Record Retrieval Program

3/10/2017

 

Verscend (formerly known as Verisk Health, Inc.) is the medical records retrieval coordinator (MRRC) for BlueChoice HealthPlan and other Blue Plans. Verscend is an independent organization that manages medical record retrieval on behalf of BlueChoice®. Verscend requests records in support of the medical record retrieval program (MRR). This program consists of medical review for the purpose of risk adjustment, Healthcare Effectiveness Data and Information Set (HEDIS) and other government-required programs related to the Affordable Care Act (ACA). The Blue Cross and Blue Shield Association selected Verscend, an independent, large, experienced health care analytics and services company, to gather medical records on behalf of BlueChoice and other Blue Plans.

We are required to use an MRRC to request records from providers in another Blue Plan’s service area. Verscend provides a centralized service for the fulfillment, sharing and coordination for medical record retrieval requests that Plans submit. It will also offer optional coding services to support risk adjustment and other government-required programs. 

Medical record retrieval functions involve:
  • Retrieving and digitizing records (e.g., PDF).
  • Associating images to patient information for better indexing.
  • Delivering records to requesting Plans through a secure online portal.
  • Storing records electronically for reference.
Verscend is contractually bound to preserve the confidentiality of our members’ protected health information (PHI) from medical records, per HIPAA regulations. Please note that patient-authorized information releases are not required in order for you to comply with this request for medical records.
  
Your support and participation in the medical record retrieval program is integral to our compliance with the Centers for Medicare and Medicaid Services (CMS) requirements. You may have already begun receiving medical records requests from Verscend. You will need to respond to these requests as soon as possible. Please use one of the methods provided in the request.
  
If you have questions about this bulletin, please contact Provider Education at 803-264-4730 or submit your question using the Provider Education Contact Form.