Medical Record Retrieval and Review

Blue Cross Blue Shield of Michigan and Blue Care Network have engaged Ciox Health to perform medical record retrieval for risk adjustment services for our commercial and Medicare Advantage members. Medical record reviews help us confirm suspected chronic conditions that haven’t been submitted on a claim for the service date range in question.

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.

• Frequently asked questions about medical record retrieval for commercial members (PDF) 
• Frequently asked questions about medical record retrieval for Michigan Medicare Advantage members (PDF)

Medical Chart Reimbursement

When a medical chart retrieval vendor asks for your medical charts, you can ask for reimbursement. 

• When Ciox Health performs risk adjustment retrievals, providers can request reimbursement by submitting this form (PDF).
• A Blue Cross HEDIS clinical consultant performs HEDIS retrievals from February through May for Blue Cross commercial and Medicare Plus Blue members. You may receive reimbursement for returned medical records by submitting the reimbursement form (PDF) or through your HEDIS clinical consultant.