Priority Health’s Annual Chart Reviews Beginning for Commercial Members
Starting in the coming weeks, Inovalon and a new partner, CIOX Health, will perform a medical record review for risk adjustment services for Individual and Small Group members on Priority Health’s behalf. This chart audit process has been developed to ensure the accuracy and completeness of the diagnostic data submitted to us.
Do providers have to comply with chart review requests?
Contracted providers must participate in chart reviews and provide the charts requested. Providers are required to submit requested charts to Inovalon or CIOX Health by March 15, 2022. If this deadline isn’t met, invoices won’t be processed, and reimbursement for copies of medical records won’t be paid.
Inovalon and CIOX Health are bound to protect the confidentiality of any protected health information it gathers from clinical records provided by hospitals and medical practices. A representative from either Inovalon or CIOX Health will follow-up with selected providers in the coming weeks about patient medical records. They can also work with your electronic medical record (EMR) on-site if that’s preferred.