SC Providers Could See Record Requests from Inovalon

S.C. Providers Could See Record Requests from Inovalon

Some BlueCross BlueShield of South Carolina and BlueChoice HealthPlan  providers are receiving requests for medical records from Inovalon, the Blue Cross and Blue Shield Association’s medical record retrieval vendor for all out-of-area requests.

The records are for members of out-of-state BlueCross plans who were treated by South Carolina providers.

Effective Jan. 1, 2018, Inovalon replaced Verscend as the medical record retrieval vendor for out-of-area record requests. This includes record retrieval for all risk adjustment projects as well as Healthcare Effectiveness Data and Information Set (HEDIS). Inovalon also provides optional services that include coding, abstraction and attestations.

Providers should return the medical records requested at no cost as part of their contractual agreement with BlueCross. If your practice contracts with a vendor that manages the release of patient information on your behalf, please work with your vendor to forward the data to Inovalon as a non-billable event. 

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.