Time to prepare for HEDIS® medical record review

Each year, Anthem Blue Cross and Blue Shield (Anthem) performs a review of a sample of our members’ medical records as part of the HEDIS® quality study. HEDIS® is part of a nationally recognized quality improvement initiative and is used by the Centers for Medicare & Medicaid Services (CMS), the National Committee for Quality Assurance (NCQA) and several states to monitor the performance of managed care organizations.

 

For 2021, Anthem will begin requesting medical records in January 2022. No special authorization is needed for you to share member medical record information with us, since quality assessment and improvement activities is a routine part of healthcare operations.

 

HEDIS® review is time sensitive, so please submit the requested medical records within the timeframe indicated in the initial HEDIS® request document.

 

Ways to submit your records:

• Remote EMR Access Service – New!
  As we published in the September edition of Provider News, we now offer the Remote EMR Access Service to providers to submit member medical record information to Anthem. If you are interested in more information, please contact us at Centralized_EMR_Team@anthem.com.
• Upload to our secure portal: Medical records can be uploaded to Anthem’s secure portal using the instructions in the request document.
• Fax: Medical records can be faxed to Anthem using the instructions in the request document.
• Mail: Medical records can be mailed to Anthem using the instructions in the request document.

 

We appreciate the quality of care you provide to our members. Your assistance is crucial to ensuring our data is statistically valid, auditable and accurately reflects quality performance.

 

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

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