12/28/22
Begins Feb. 1, 2023, through April 27, 2023
Blue Cross and Blue Shield Federal Employee Program (FEP®) collects performance data using specifications published by the National Committee for Quality Assurance (NCQA) for Healthcare Effectiveness Data and Information Set (HEDIS®). HEDIS is a comprehensive set of standardized performance measures that assess quality of care and outcomes HEDIS is the most widely used and nationally accepted effectiveness of care measurement available and is used to ensure compliance with the Federal Employees Health Benefits Program (FEHBP) requirements.
To meet this annual quality reporting requirement, BCBS FEP will be collecting medical records using internal resources and leveraging an independently contracted third-party vendor Episource. This medical retrieval process will begin in February 2023 and run through the end of April 2023.
If you receive a request for medical records, we ask that you reply within five (5) business days of receipt of this request. Your cooperation is crucial to ensure that data is reported completely, accurately, and timely. BCBS FEP or Episource may be contacting your office or facility in February 2023 to identify a key contact person and to ascertain which data collection method your office or facility prefers (fax, secure email, sFTP or onsite). (Appointments for onsite visits will be scheduled with your staff, if applicable.) You will then receive a letter outlining the information that is being requested, and the medical record request list with members’ names and the identified measures that will be reviewed.
Patient authorization for release of medical record data is not required. These reporting activities are considered health care operations under the Health Information Portability and Accountability Act (HIPAA) of 1996 and its implementing regulations (45 C.F.R. Parts 160 and164), and the Health Information Technology for Economic and Clinical Health (HITECH) Act, as incorporated in the American Recovery and Reinvestment Act (ARRA) of 2009, and its implementing regulations, each as issued and amended.
We appreciate your time and continued collaboration. If you have any questions about medical record requests, please contact the BCBS FEP Quality Improvement (HEDIS) Department at 1-(888) 907-7918.
HEDIS is a registered trademark of NCQA.
Episource LLC is an independent third-party vendor that is solely responsible for the products or services they offer. BCBS FEP makes no endorsement, representations or warranties regarding any products or services offered by independent third-party vendor. If you have any questions regarding the services they offer, you should contact the vendor directly.