December 31, 2020
Why it matters:
Blue Cross and Blue Shield Federal Employee Program (FEP) collects performance data according to National Committee for Quality Assurance (NCQA) specifications for Healthcare Effectiveness Data and Information Set (HEDIS®). HEDIS is the most widely used and nationally accepted effectiveness of care measurement available and used for Federal Employees Health Benefits Program (FEHBP).
How you can help:
BCBS FEP will be collecting medical records using internal resources and an independently contracted third party vendor, Change Healthcare.
The goal:
Change Healthcare will reach out to schedule the medical record retrieval. They will provide a medical record request list with members' names and identify the measures to be reviewed.
Submit medical records within 5 business days using one of these methods:
- via secure email
- fax
- remote electronic record (EMR) download
- onsite scanning by a Change Healthcare medical record technician
Medical records not received timely will trigger outreach in February or March 2021 by BCBS FEP or the vendor referenced above.
Next steps:
- Identify a key contact person and to ascertain which data collection method your office or facility prefers (fax, secure email, SFTP (Secure File Transfer Protocol) or onsite) for scheduled appointments.
- Watch for letter outlining the information that is being requested, and the medical record request list with members' names and the identified measures for review.
Related:
Patient authorization for release of medical record data is not required. These 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. For questions about medical record requests, contact the BCBS FEP Quality Initiative (HEDIS) Department at 1-888-907-7918.
HEDIS is a registered trademark of NCQA.
Change Healthcare 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.