Education & TrainingMedicaidNovember 13, 2023

Submission of medical records for pseudo claims

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Submitting medical records for pseudo claims can be a good way to gain credit and close member gaps for services potentially unaccounted for through missed coding opportunities.

There are several ways to submit medical records for review by Empire BlueCross BlueShield HealthPlus (Empire) to close member gaps and improve your provider score.

This guide outlines requirements in medical records to close member gaps for each quality measure where medical records are accepted.

Refer to attachment to view full details

Empire BlueCross BlueShield HealthPlus is the trade name of HealthPlus HP, LLC, an independent licensee of the Blue Cross Blue Shield Association.

NYBCBS-CD-025799-23

ATTACHMENTS: Submission of medical records for pseudo claims (pdf - 5.83mb)