Medicare Advantage providers may receive requests from Blue Cross and Blue Shield of Oklahoma or our vendor Advantmed from January through June 2024 to collect data for Healthcare Effectiveness Data and Information Set (HEDIS®) measures. The data you provide helps us monitor the quality of our members’ care and their health outcomes.
How You Can Help
Either BCBSOK or Advantmed may contact you by fax or phone to provide details about the records needed and how you can return them to us. When requested, please promptly provide complete and accurate records.
Patient authorization isn’t required to release these records, as their collection and review is considered a component of health care operations under the Health Information Portability and Accountability Act.
The Data We’re Seeking
We collect data for HEDIS measures developed by the National Committee for Quality Assurance, including:
- Controlling High Blood Pressure
- Colorectal Cancer Screening
- Comprehensive Diabetes Care
- Transitions of Care
Please contact your Provider Network Representative if you have questions.
Other Records Requests
We also request medical records throughout the year for risk adjustment, focusing on chart reviews and the accuracy of risk-adjustable codes submitted to the Centers for Medicare & Medicaid Services.
HEDIS is a registered trademark of NCQA.
Advantmed, LLC is an independent company that has contracted with BCBSOK to request medical records for HEDIS reporting.
BCBSOK makes no endorsement, representations or warranties regarding third-party vendors and the products and services they offer.