Physicians/Specialists
Facilities/Hospitals
Ancillary
Publication Date: 
2019-12-11

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) uses LKClinicalDataExchange (CDX) to help providers easily receive and fulfill requests for patient charts.

Key Points

  • On July 31, we added a new link to Blue e. Since then, providers have used CDX to provide medical records for quality reviews.
    • Providers access CDX via the Blue e "Home" tab, by selecting "Clinical Data Exchange" under "Health Management."
  • The CDX site allows providers to:
    • Retrieve their risk-adjustment and HEDIS patient medical record request lists
    • Upload the requested records
    • Upload medical records to close gaps identified in the various quality reports, without having to first receive a request through CDX
  • For the upcoming annual HEDIS Hybrid collection, lists of chart requests will be delivered via the CDX platform.
  • For request-based collections, providers and/or their assignees will receive email requests for patient documentation.
    • If the user already established Blue e access, these emails will contain a link to the Blue e platform.
    • Once logged in to Blue e, providers can access the CDX provider dashboard with a single sign-on if the Blue e access is configured for quality or risk-adjustment.
    • All requests for medical charts will populate a queue in the provider dashboard.
  • Other medical record requests:
    • Starting in the late spring of 2020, Medicare Advantage and commercial Affordable Care Act (ACA) risk-adjustment teams will also use CDX for medical record-review projects when Blue Cross NC personnel are the initial contact for the collection and the insurer does not have direct access to the provider's EMR. Please note that our risk-adjustment team will continue using an outside vendor for many record collections in 2020.
    • Until further notice, records collected for ACA and the Centers for Medicare and Medicaid Services RADV audits will still be collected via email and fax.
    • Requests for medical records from other areas of Blue Cross NC will still be collected under those areas' already-established processes.
    • For both risk-adjustment and HEDIS, most medical records collected for out-of-state Blue Plans will still be collected via Inovalon. But in 2020, Blue Cross NC will start collecting medical records for out-of-state Blue Plan Medicare Advantage employer group members who reside in North Carolina.

Questions?
Please contact your Quality Management Consultant with any questions about quality medical record requests. You can also: