Nov 1, 2023

Medical record vendor name change

One of our medical record requesting vendors has changed their names. You may have seen requests for medical records from other Blue plans through our vendor Inovalon in the past during our Healthcare Effectiveness Data and Information Set (HEDIS®) season and for any risk adjustment services. Inovalon has completed a corporate reorganization whereby they’re transferring all HEDIS and risk adjustment services to ComplexCare Solutions (CCS), Inovalon’s wholly owned subsidiary.

The Medical Records Review program supports plans’ HEDIS and risk adjustment efforts and requires use of a Blue Cross Blue Shield Association contracted vendor when medical records are needed for services rendered outside of the control/home plan’s service area. The vendor provides a centralized service for the coordination and fulfillment of out-of-area medical record requests submitted by plans.

All communication materials reflecting CCS branding will begin January 1, 2024. In the meantime, CCS will send out several communications to providers/sites informing them of the upcoming change as it relates to their business operations. Any requests received prior to January 1, 2024 will still use the Inovalon branding.