September 26, 2013

HHA-13-14
DC-13-14
ASC-13-15
MS-13-17

BC-13-17
SA-13-14
HP-13-14

To:

All Blue Cross and Blue Shield of Kansas Contracting Providers

From:

Connie Winkley – Education/Communication Coordinator
Institutional Provider Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association

Subject:

Verisk chosen as Medical Record Retrieval Coordinator for BCBSKS member claims

Blue Cross and Blue Shield of Kansas is pleased to announce that Verisk Health has been selected to gather medical records on its behalf and on behalf of other BlueCross and/or BlueShield companies. Blue Plans use Verisk Health to retrieve medical records to support HEDIS, risk adjustment and government required programs related to the Affordable Care Act.

Verisk Health is an experienced healthcare analytics and services company and best-in-class supplier. Verisk will provide an efficient centralized process to coordinate medical record requests from BlueCross and/or BlueShield companies across the country and help reduce multiple requests for patient data.

Effective medical record retrieval services play a fundamental role in driving optimal quality reporting outcomes and ensuring appropriate risk scores.

All pertinent and complete medical records must be provided or made available by the contracting provider. This includes requests from Verisk Health. We are working diligently to make this process as simple as possible.

Verisk Health may be contacting providers in the next few weeks to coordinate retrieval of medical records. For your convenience medical records may be submitted to Verisk in the following ways:

HIPAA/Privacy
Verisk Health is contractually bound to preserve the confidentiality of health plan members’ protected health information (PHI) obtained from medical records, in accordance with HIPAA regulations. Please note that patient-authorized information releases are not required in order for you to comply with these requests for medical records.

Providers are permitted to disclose protected health information (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, please visit http://www.hhs.gov/ocr/privacy.

If you have questions regarding this newsletter, please contact your Institutional Provider Representative. Denny Hartman can be reached at 1-316-269-1602; Cindy Garrison at 1-785-291-8862 and Janne Adams-Denton at 1-785-291-8813.

 

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