Empire announces changes to post-payment audits conducted on our behalf

Change Healthcare will transition out of the post-payment hospital bill audit (HBA) program by the end of 2022. Effective immediately, Empire BlueCross BlueShield’s (“Empire”) complex and clinical audit (CCA) team will conduct the HBA program. For a short period of time, Change Healthcare may continue to contact you to finalize any work that is in process, or already scheduled.

 

Empire continues to work with Cotiviti as a post-payment DRG validation audit partner. Effective immediately, the Empire CCA team is assuming a larger role in conducting post-payment DRG validation audits and DRG readmission audits. In addition to receiving requests from Empire’s CCA team, network-participating providers may continue to receive letters from Cotiviti requesting access to medical records for the purpose of conducting these audits. We will do our best to avoid duplicate medical record requests from Empire and Cotiviti. 

 

Thank you for your continued efforts to expedite medical record requests. 

 

This notification applies to all lines of business and all markets. If you have questions about this notification, please contact the Provider Services call center.

 

2120-0522-PN-NY