For Providers: What Do I Need to Know About Medical Chart Reviews?

Medical chart reviews help Blue Cross Blue Shield of Michigan and Blue Care Network confirm suspected chronic conditions that haven’t been submitted on a claim for the service date range in question.

Medical chart retrieval for risk adjustment

We've partnered with Ciox Health to perform medical record retrieval for risk adjustment services for our commercial and Medicare Advantage members. 

Conditions that are actively being treated or those that may affect the patient's treatment should be reported on a claim at least once every calendar year. These reviews can also help identify patients who may benefit from our care and disease management programs.

Note: If you're contracted with us, you're required to participate in these reviews.

How to get reimbursed

When a medical chart retrieval vendor asks for your medical charts, you can ask for reimbursement. Use the appropriate PDF to get reimbursed:

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Related forms and documents

Need more help with medical chart review? Read these detailed PDFs for more information.

BCBSM Commercial Medical Record Retrieval FAQ (PDF)
Michigan Medicare Advantage Medical Record Retrieval FAQ (PDF)