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March 2015

Blues retain Mobile Medical Examination Services Inc™, Inovalon™ for Home Health Reviews

This month, Blue Cross Blue Shield of Michigan and Blue Care Network will once again retain two independent companies to conduct Home Health Reviews, formerly known as in-home assessments, for eligible Blue Cross and BCN Medicare Advantage members.

The reviews are part of our members’ coverage and are completely voluntary.

Licensed health care professionals from Mobile Medical Examination Services Inc., or MedXM, and Inovalon will provide the personalized Home Health Reviews. These reviews will include a medical history review, brief physical exams and documentation of any existing medical conditions. They don’t replace any care members receive from their physicians. Also, the MedXM and Inovalon health professional can’t access a member’s medical history or write prescriptions.

This type of outreach helps support our members’ health and your ongoing care. It also provides documentation of any current medical conditions, helping to guide our care management programs.

We’ll provide information obtained from these reviews to the Centers for Medicare & Medicaid Services as part of our risk-adjustment initiatives. We’ll also share it with you to support your patient care efforts.

Please place a copy of these reviews in your patients’ medical records. You may also want to encourage patients to schedule an office visit following a Home Health Review to discuss the review with them.

If you have any questions, contact your provider consultant.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2014 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
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