IMPORTANT: Medical Records Retrieval Project
Date: 07/08/24
Superior HealthPlan is requesting your cooperation in providing access to specific member medical records to facilitate a Risk Adjustment chart review. Risk Adjustment is the payment methodology used by the Centers for Medicare and Medicaid Services (CMS) and Health and Human Services (HHS) for Wellcare By Allwell, STAR+PLUS Medicare-Medicaid Plan (MMP), and Ambetter from Superior HealthPlan members.
The purpose of these chart reviews is to verify that information reported to Superior, and ultimately to CMS and HHS via claims or encounter data, includes all pertinent diagnosis codes at accurate levels of specificity.
Please Note: Superior has executed a Business Associate Agreement with both Advantmed and Datavant (formerly CIOX Health).
Advantmed and Datavant have been engaged by Superior to retrieve medical records selected as part of this chart review. Any information shared during this review will be kept in the strictest of confidence, in accordance with all applicable state and federal laws regarding the confidentiality of patient records, including current Health Insurance Portability and Accountability Act (HIPAA) requirements. Superior appreciates your cooperation with this medical record review and will work with you to minimize disruptions in member care activities.
You will have the option to submit medical records in the following ways:
- Secure email
- Fax
- FedEx
- Remote Electronic Medical Record (EMR) download
- Onsite scanning performed by an Advantmed medical record technician
Please anticipate a call or fax from Advantmed or Datavant to schedule the medical record retrieval in the upcoming weeks.
For any questions, please email SHP_RiskAdjustment@SuperiorHealthPlan.com.