Upcoming CMS Risk Adjustment Data Validation (RADV) Medical Records Request


Beginning July 2022, you may receive a request for medical records from the Blue Cross and Blue Shield of Texas IVA Team. As a provider, your role is essential to the Affordable Care Act (ACA) Risk Adjustment (RA) program with The Centers for Medicare and Medicaid Services (CMS). If your patients are selected to be included, Blue Cross and Blue Shield of Texas (BCBSTX) requests your complete cooperation and commitment in fulfilling the requirements of the (CMS)-mandated risk adjustment chart review.

The BCBSTX IVA Team will begin outreaching to providers in early July to inquire and follow up regarding medical records request sent at the end of June. We understand this is a very busy time and appreciate your compliance with CMS requirements and timely delivery of the requested medical record(s).

Didn’t I already provide these records?

The BCBSTX IVA Team makes every effort to locate medical records previously submitted before sending new requests.

Medical records are requested throughout the year for many different purposes. Please review this timeline of all major medical record request projects in 2022.

For more information: please contact your local Provider Network Consultant (PNC) or email the BCBSTX Texas IVA team.